Men with low levels of the male sex hormone testosterone need not fear. Testosterone replacement therapy will not increase their risk of prostate cancer. This is the finding of an analysis of more than a quarter-million medical records of mostly white men in Sweden. Investigators at NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center led this research.
Fear Not: Testosterone Replacement Therapy Not Linked to Prostate Cancer
The international team of study authors will present these results on May 9. That will happen at the annual meeting of the American Urological Association in San Diego, Calif. In the study, researchers found that, as a group, men prescribed testosterone for longer than a year had no overall increase in risk of prostate cancer. In fact, their risk of aggressive disease is reduced by 50 percent.
Insight from a Large-Scale Study: Prostate Cancer Risk and Testosterone Therapy
“Our research suggests that doctors should continue to monitor risk factors for prostate cancer in men undergoing testosterone therapy. These risk factors include being over 40 years old, being of African-American descent, or having a family history of the disease. However, doctors should not avoid prescribing testosterone therapy to suitable patients out of concern that it might increase the risk of prostate cancer,” says Stacy Loeb, MD, MSc, the lead investigator of the study and a urologist at NYU Langone.
Long-Term Testosterone Therapy: Decreased Risk of Aggressive Prostate Cancer
Loeb points out that much of the concern over cancer risk is that, as part of standard therapy for advanced prostate cancer, tumor growth decreases by drugs that drastically reduce rather than increase male hormones. “But when used appropriately by men with age-related low testosterone who are otherwise healthy, testosterone replacement improves sexual function and mood.”
Testosterone Replacement Therapy: Unfounded Fears and Real Benefits
The researchers say the use of testosterone therapy — taken by mouth, gel patch, or injection to treat “low T” — has skyrocketed in the past decade. Its popularity is a consequence, experts say, of an aging “boomer” population and heavy drug industry marketing. And has come about despite its unknown, long-term health risks.
Dispelling Myths: Testosterone Therapy Doesn’t Increase Prostate Cancer Risk
According to some surveys, the use of testosterone therapy has more than tripled since 2001. More than 2 percent of American men in their 40s and nearly 4 percent of men in their 60s taking it. Testosterone levels drop naturally by about 1 percent per year in men past their 30s.
The Swedish Study: Understanding Prostate Cancer Risk in Testosterone Therapy Patients
Specifically, the current study found that 38,570 of the men developed prostate cancer between 2009 and 2012. Of these men, 284 had prescriptions for testosterone replacement therapy before they had the prostate cancer diagnosis.
Towards a Balanced Understanding: Testosterone Levels and Prostate Cancer
We compared their records with 192,838 men who did not develop prostate cancer, of whom 1,378 had used testosterone therapy. Researchers made a note. Their first analysis showed that there was a 35 percent increase in prostate cancer in men. This was right after they started therapy. However, the increase was specific. It was only in low-risk prostate cancers. These cancers have a low risk of spreading. It was likely a result of more doctor visits and biopsies they performed early on.
Stacy Loeb’s Research: A New Perspective on Testosterone Therapy and Prostate Cancer
The authors stressed the long-term reduction in aggressive disease. It was only in men after more than a year of testosterone use. The risk of prostate cancer did not differ between gels and other types of preparations. “Overall, our study suggests what is best for men’s health. It is to keep a balance on the testosterone levels and within a normal range,” says Loeb. Additionally, he gives a suggestion for men with testosterone levels below 350 nanograms per deciliter. He said they should seek medical advice about whether they should consider testosterone therapy.
Next Steps in Research: Understanding the Role of Low Testosterone in Aggressive Prostate Cancer
For the study, researchers matched and analyzed data from the National Prostate Cancer Register and the Prescribed Drug Register in Sweden.
The country is one of the few in the world that collects detailed information on cancer and medication prescriptions for its entire population.
Loeb says the team next plans further studies to determine why low testosterone levels might trigger aggressive prostate cancer. And why maintaining normal levels may protect against aggressive disease.
Story Source: https://www.sciencedaily.com/releases/2016/05/160507143326.htm
The above post is reprinted from materials provided by NYU Langone Medical Center / New York University School of Medicine.
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