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Is There a Link between Low Testosterone and Prostate Cancer?

Written by Author - Authors Medical experts of the National HRT Clinic - October 12, 2015

There has long been a discussion in the medical community about the possible link between testosterone and prostate cancer. Conversation exists on both side of the topic as to whether testosterone treatment fuels the growth of tumors in men diagnosed with prostate cancer, or if low testosterone levels are actually the precursor to a greater risk of developing this condition.

Prostate Cancer and Low T

Does testosterone cause prostate cancer risks to increase in later years of one’s life – primarily during a man’s sixties? This stage of life is when the highest level of diagnosis of prostate cancer takes place, and it typically corresponds with a decline in testosterone production.

Emerging research is leading many in the field to challenge and change long-held viewpoints about who can benefit from testosterone replacement treatment.

Here is what is currently known about this correlation between low testosterone and prostate cancer:

  • Somewhere between the age of thirty and forty, a man’s production of testosterone begins to slow. This decline continues at a rate of about 1 to 2 percent each year.
  • Many men start to exhibit signs or symptoms of hypogonadism or andropause in their fifties or sixties.
  • The risk of developing prostate cancer increases with age, and is most often seen during the seventh decade of life (one’s sixties).
  • Low testosterone levels are typically diagnosed in men who have prostate cancer.
  • Men with higher levels of testosterone (normal range) have a reduced risk of developing prostate cancer.

Changing viewpoints based on positive studies and outcomes is providing a new way of treating men diagnosed with prostate cancer, as well as helping others to possibly avoid this situation by restoring balance to decreasing testosterone levels. The possibility of early use of testosterone therapy and prostate cancer risk decline is something that many medical professionals are now looking into for symptomatic men dealing with the effects of Low T.

The Effect of Testosterone Replacement Treatment on Prostate Cancer Risk

There have long been concerns over men having an increased risk of the redevelopment of tumors after testosterone replacement. Prostate cancer recurrence risk has not been shown to be an issue based on the following results:

  • Dr. Abraham Morgentaler, director of Men’s Health Boston and an associate clinical professor of surgery at Harvard Medical School, published a book titled “Testosterone for Life,” and cites that some men who have previously been treated for prostate cancer can take testosterone treatment without increasing their risk of a cancer recurrence.
  • A 2004 Journal of Urology article by Drs. Joel Kaufman and James Graydon examined 7 men who underwent treatment with testosterone after prostate cancer, and none experienced a recurrence.
  • This report was followed up by research from both Case Western Reserve University School of Medicine and Baylor College of Medicine where the same positive results were seen.
  • Another published report, this one by Dr. Michael Sarosdy, examined 31 men who had received brachytherapy (radioactive seeds) for the treatment of prostate cancer before receiving testosterone replacement. None of these men had any evidence of cancer recurrence after an average follow-up of five years.

By examining these results, there is little evidence of increased risk of the redevelopment of prostate cancer and testosterone replacement usage. Of course, every situation is unique, and all aspects of this therapy must be discussed with one’s doctor before treatment begins.

Testosterone Replacement Treatment Effect on PSA and Prostate Volume

TestosteroneA published Cancer Network report in January 2015 examined the effect of testosterone replacement and prostate cancer in regards to PSA levels following hormone replacement therapy. This particular study treated 16 men with asymptomatic metastatic prostate cancer. Each had rising PSA (prostate-specific antigen) levels and evidence of resistance to ADT (androgen deprivation therapy).

Here are the findings of this study:

  • 7 of the men had decreases in PSA levels between 30 and 90 percent.
  • 4 men stayed on testosterone treatment for 1 to 2 years and maintained steady low PSA levels.
  • 5 of 10 men who had imaging scans to measure the level of their disease had tumor shrinkage of greater than 50 percent.

It was also noted that testosterone therapy inhibits the growth of androgen receptors that can lead to ADT resistance. This enabled the cancer cells to respond better to treatment. As a result of careful and specific testosterone therapy, prostate cancer treatment became more effective in those dealing with ADT resistance.

Another positive report discusses “The Effect of Testosterone Replacement on PSA and Prostate Volume” in regards to testosterone and PSA levels in men. TRT has been shown to increase the prostate size and elevate PSA levels in men with hypogonadism to a more balanced state. (please link this

Can Testosterone Replacement Therapy Prevent Prostate Cancer?

In assessing a man’s overall risk of developing prostate cancer in the future, there are many variables to take into consideration. At this point in time, testosterone replacement treatment is only recommended in instances where blood test results show that T levels are low, and symptoms of Low T are present.

The correlation between low levels of testosterone and prostate cancer risk is clear. Not only are higher T levels found to decrease the risk of progression of this disease, but patients with PCa and Low T have poor progression factors and higher tumor burden before treatment onset. (please link this

There is clearly a direct relationship between low testosterone levels and prostate cancer for many men. Being proactive by contacting a hormone replacement specialist for proper blood testing is crucial if symptomatic signs of Low T are present. Fatigue, muscle loss, weight gain, low libido, and erectile dysfunction are some of the warning signs that testosterone decline might be present.

It is essential to pay attention to any changes in one’s health, well-being, or emotional state that could signify that something is wrong. Early diagnosis of any medical condition can improve the odds of recovery. Doctors and medical advisors at National HRT are available to answer any questions during a complimentary telephone consultation.

Medically reviewed by   Reviewers National HRT Staff - Updated on November 21, 2023

Please note that the information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

References

  1. The Impact of Prostate Cancer and Hormonal Therapy on Bone Gerald L Andriole, Jr, MD
  2. Medical News Today
  3. Testosterone treatment and the risk of aggressive prostate cancer in men with low testosterone levels. Walsh TJ, Shores MM Krakauer CA, Forsberg CW, Fox AE, Moore KP, Korpak A, Heckbert SR, Zeliadt SB, Kinsey CE, Thompson ML, Smith NL, Matsumoto AM PLoS One. 2018 Jun 22;13(6):e0199194.
  4. UW Medicine
  5. Morgentaler A, Magauran D, Neel D, et al. Recurrence rates following testosterone therapy in a large clinical cohort of men with prostate cancer. Data presented in poster format at the American Urological Association 2018 annual meeting in San Francisco, May 18–21. MP17-03.
  6. Low Free Testosterone and Prostate Cancer Risk: A Collaborative Analysis of 20 Prospective StudiesEleanor L. Wattsa,’Correspondence information about the author Eleanor L. WattsEmail the author Eleanor L. Watts, Paul N. Applebya, Aurora Perez-Cornagoa, H. Bas Bueno-de-Mesquitab,c,d,e, June M. Chanf,g, Chu Chenh, Barbara A. Cohni, Michael B. Cookj, Leon Flickerk,l, Neal D. Freedmanj, Graham G. Gilesm,n, Edward Giovannuccio,p,rr, Randi E. Gislefossq, Graeme J. Hankeyk, Rudolf Kaaksr, Paul Knekts, Laurence N. Kolonelt, Tatsuhiko Kubou, Loïc Le Marchandt, Robert N. Lubenv, Tapio Luostarinenw, Satu Männistöx, E. Jeffrey Mettery, Kazuya Mikamiz, Roger L. Milnem,n, Kotaro Ozasaaa, Elizabeth A. Platzbb, J. Ramón Quiróscc, Harri Rissanens, Norie Sawadadd, Meir Stampfero,p, Frank Z. Stanczykee, Pär Stattinff, Akiko Tamakoshigg, Catherine M. Tangenhh,ii, Ian M. Thompsonjj, Konstantinos K. Tsilidisd,kk, Shoichiro Tsuganedd, Giske Ursinq,ll,mm, Lars Vattennn, Noel S. Weissoo, Bu B. Yeapk,pp, Naomi E. Allenqq,, Timothy J. Keya,, Ruth C. Travisa,
  7. Testosterone treatment and the risk of aggressive prostate cancer in men with low testosterone levels Thomas J. Walsh , Molly M. Shores, Chloe A. Krakauer, Christopher W. Forsberg, Alexandra E. Fox, Kathryn P. Moore, Anna Korpak, Susan R. Heckbert, Steven B. Zeliadt, Chloe E. Kinsey, Mary Lou Thompson, Nicholas L. Smith, Alvin M. Matsumoto
  8. Dr. Tracy Garpin
  9. Culig Z, et al. Androgen receptors in prostate cancer. J Uro. 2003;170(4):1363–1369.