Long-Term Low T Treatment Not Linked to Prostate Cancer

Contrary to previous evidence, a new study published in The Journal of Urology found that long-term testosterone (T) therapy does not increase the risk of prostate cancer (PCa) in men with hypogonadism.

"Although considerable evidence exists indicating no relationship between testosterone and increased risk of developing PCa, decades of physician training with the notion that testosterone is fuel for PCa made it difficult to dispel such fallacy and the myth continued to persist,” said lead investigator Ahmad Haider, MD, PhD, in a press release. “Nevertheless, in the absence of long-term follow-up data demonstrating reduced risk of PCa in hypogonadal men who are receiving T therapy, considerable skepticism remains throughout the medical community, and this is an expected natural and acceptable path of medical and scientific discourse.”

Among 3 study cohorts with a combined 1023 hypogonadal men receiving T therapy who were followed for up to 17 years, there were only 6 PCa diagnoses in the first cohort, 5 in the second cohort, and no positive biopsies in the third cohort, according to the researchers. Furthermore, the PCa incidence per 10,000 patient-years across the cohorts was significantly lower than the incidences reported by the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and the European Randomized Study of Screening for Prostate Cancer.

As a result, the authors concluded, “If guidelines for T therapy are properly applied, T treatment is safe in hypogonadal men.”

“In view of the current evidence, clinicians are compelled to think this over and cannot justify withholding T therapy in hypogonadal men, also in men who have been successfully treated for PCa,” Dr. Haider said.