Men of any age can present with the symptoms of low testosterone – including erectile dysfunction, fatigue, difficulty concentrating, decreased muscle mass and bone density. Is it safe to treat these symptoms with testosterone replacement therapy?
There are several ways to treat men with low testosterone: the most common are gels, patches, and injections. These treatments are effective for relieving symptoms, and are generally safe.
There is controversy as to whether men with a history of prostate cancer should receive hormone treatment for low testosterone. Since the risk of prostate cancer can theoretically increase with increased testosterone levels, the FDA says that testosterone replacement therapy is contraindicated for men with a history of prostate cancer.
However, studies have not shown a clear link between testosterone supplementation and prostate cancer, and an emerging movement of physicians are pushing for select symptomatic men with a history of prostate cancer to be allowed treatment for low testosterone levels.
If doctors can strictly monitor patients for prostate cancer, including regular digital rectal exams and prostate specific antigen tests, I don’t see why we can’t reconsider treatment with testosterone replacement therapy – which can greatly improve quality of life – for men who have had their prostate cancer cured.
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{ 3 comments }
Lack of studies showing a clear link between testosterone supplementation and increase in prostate cancer risk is not enough to convince me to start treating survivors of an exquisitely hormone sensitive cancer with hormone supplements.
It does not make any practical sense and I think physicians who choose to treat prostate cancer survivors with testosterone are diverging significantly from standards of care and taking miscalculated risks.
(While looking at studies that claim that hormone replacement do not raise the risk of prostate cancer, I noticed their follow-up periods are extremely short, like 1-2 years. They are also mostly looking at incident cases of prostate cancer and not recurrence.)
There seems to be a divide amongst this issue arising recently. Balancing quality of life and chances of reoccurance with respect to testosterone.
Testosterone is extremely important for men’s mental, emotional, and physical well-being. The decision to cut off the source of this well-being for the rest of a man’s life should not be taken lightly.
It’s nice to see that this issue is finally opening up to debate. Maybe in the future we’ll start seeing more research into the possibility that low testosterone actually contributes to prostate cancer. The evidence is building…
Cheers!
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