In spite of the theoretical increase in prostate cancer risk following TRT, there is currently no evidence that testosterone administration can initiate or promote a de novo or pre-existing prostatic malignancy in hypogonadal men. In fact, there are strong indications that normal testosterone levels play a protective role in the natural history of prostate cancer. Many studies have demonstrated that a low testosterone level prior to treatment is an independent predictor of a more aggressive, high-grade cancer, an increased likelihood of extraprostatic disease at the time of diagnosis, and a decreased likelihood of a favorable treatment response. Nevertheless, most of these trials are limited in sample size and duration of therapy. Therefore, until the true risk of TRT has been established in long-term studies, it is crucial to carefully screen and closely monitor these men for occult prostate cancer.
Posted: 07/19/2006; Int J Impot Res. 2006;18(4):323-328. © 2006 Nature Publishing Group