Testosterone replacement therapy (TRT) does not appear to increase a man’s risk for aggressive prostate cancer, according to a team of American and Swedish researchers.
The study, presented last month at the American Urological Association’s annual meeting in San Diego, California, examined almost a quarter-million medical records of Swedish men found in the National Prostate Cancer Register and the Prescribed Drug Register in Sweden.
Between 2009 and 2012, 38,570 cases of prostate cancer were diagnosed. The researchers also analyzed data from 192,838 age-matched controls who did not have prostate cancer.
Of these groups, 284 men with prostate cancer and 1,378 men in the control group had filled prescriptions for TRT.
Overall, no association between TRT and prostate cancer risk was found. Men on TRT were more likely to develop “favorable-risk” prostate cancer, but this result may have been due to frequent visits to the doctor and early biopsies. (Favorable-risk refers to prostate cancer that is not aggressive and may be managed by active surveillance rather than immediate treatment.)
However, risk for aggressive disease was cut in half for men who had been on TRT for a year or more. This was “a novel finding that warrants further investigation,” the researchers wrote in their abstract.
“Overall, our study suggests that what is best for men’s health is to keep testosterone levels balanced and within a normal range”
Past studies on the relationship between TRT and prostate cancer have had mixed results. There have also been concerns that TRT might fuel the growth of prostate cancer tumors in men with advanced disease.
“Based on our findings, physicians should still be watching for prostate cancer risk factors—such as being over the age of 40, having African-American ancestry, or having a family history of the disease—in men taking testosterone therapy, but should not hesitate to prescribe it to appropriate patients for fear of increasing prostate cancer risk,” said lead investigator and urologist Stacy Loeb, MD, MSc of the NYU Langone Medical Center in a press release.
“Overall, our study suggests that what is best for men’s health is to keep testosterone levels balanced and within a normal range,” Dr. Loeb added.
Loeb, Stacy, MD, MSc, et al.
“Testosterone Therapy and Prostate Cancer Risk”
(Abstract presented at the annual meeting of the American Urological Association, May 9, 2016, San Diego, California)
Cancer Therapy Advisor
Hoffman, Jason, PharmD, RPh
“Active Surveillance Should Be Considered for Favorable-risk Prostate Cancer”
(September 17, 2015)
NYU Langone Medical Center
“Testosterone Therapy Does Not Raise Risk of Aggressive Prostate Cancer, Study Suggests”
(Press release. May 9, 2016)