Low testosterone is affecting more men every day as unhealthy lifestyle choices become our daily norm. Through these choices, a range of conditions can be triggered — which includes hypogonadism, also referred to as testosterone deficiency. Testosterone replacement therapy is a promising treatment but is testosterone linked to prostate cancer somehow?
Hypogonadism has emerged as a topic of growing interest and concern as other medical issues have been found to promote the development of low testosterone.
To treat your testosterone deficiency, your doctor may prescribe testosterone replacement therapy — more commonly known as “TRT.” Testosterone replacement therapy can “replace” the lack of testosterone in your body and increase your levels so your testosterone can get back into the normal range.
TRT has very limited immediate side effects, mainly constituting acne and swelling in the ankles. Some claim a link between testosterone and prostate cancer, which mainly stems from the fact that prostate cancer is one of the most common types of cancer that has been theorized to feed on androgens.
But are testosterone and prostate cancer really linked? Let’s look into what research findings have indicated to date.
Prostate Cancer Symptoms
Prostate cancer is a type of cancer affecting the male reproductive system, potentially reaching past the prostate, which is located underneath the bladder. It can, therefore, also affect the penis, seminal vesicles, and testicles.
Prostate cancer is one of the most commonly diagnosed cancers in the U.S., amounting to roughly 15% of cancers — which comes out to be approximately 2 million people.
Some of the most significant symptoms of prostate cancer are related to urination. Whether it’s:
- difficult for you to start urinating,
- maintaining a steady urine stream,
- or you either urinate too often (primarily at night),
- or have a hard time emptying your bladder all the way,
you may want to discuss these early signs with your physician and reach out for a prostate screening.
Additional prostate cancer symptoms include persistent back, hip, or pelvis pain, or pain while ejaculating. If you notice some of these signs, make sure to reach out to your doctor!
Causes of Prostate Cancer
Age is one of the most profound causes of prostate cancer as its risk increases as we grow older, mainly impacting men over the age of 50. Unhealthy dietary patterns and obesity can further contribute to the development of the disease.
Other causes of prostate cancer include a higher risk in individuals with a family history of the disease. It’s also more common in certain ethnicities, affecting black and Asian men more so than white men.
Does Taking Testosterone Increase Your Risk of Prostate Cancer?
With prostate cancer being one of the most common types of cancer in the U.S., many theories surrounding potential risks and side effects have emerged. Some believe that androgens promote the development of prostate cancer cells, however, more studies are being published and have found no increase in prostate cancer for men taking testosterone replacement therapy.
Nonetheless, more randomized large-scale trials are needed to deepen our understanding of the relationship between testosterone and prostate function.
Below are just a few studies and reviews conducted on prostate cancer and testosterone.
TRAVERSE Study & Other Research Findings
Results of the TRAVERSE clinical trial were published in 2023 and investigated the cardiovascular safety of testosterone replacement therapy. Since then, the study has garnered increased interest due to the large enrollment of 5,246 males — making results more profound and reliable.
The study also provided many new insights on hypotheses pertaining to TRT and offered answers to countless burning questions.
This multicenter randomized controlled trial examined males between ages 45 to 80, who were either at higher risk for cardiovascular disease or had already been diagnosed with the disease. All patients had to have reported symptoms of low T (such as low libido and erectile dysfunction) and had to have two low testosterone lab values — defined by the American Urological Association as lower than 300 ng/dL for total testosterone.
At random, patients were assigned a daily testosterone gel (different doses were available), while others were assigned a placebo gel.
Testosterone replacement therapy was then found to be non-inferior to the placebo, meaning TRT did not lead to more cardiovascular endpoints compared to patients in the placebo group. In fact, there were more cardiovascular endpoints noted in the group taking the placebo.
Now what does that have to do with testosterone and prostate cancer?
The study, while excluding patients with a previous history of prostate cancer or increased PSA (prostate-specific antigen), further presented findings regarding the development of prostate cancer.
Out of 5,246 participants, only 23 developed prostate cancer — making it an extremely low number to develop the disease. Moreover, individuals affected with prostate cancer were almost evenly distributed between the testosterone (0.5%) and placebo (0.4%) groups, with 12 and 11 patients respectively.
These findings suggest that TRT may be safe in selected individuals and that taking testosterone doesn’t increase your risk of developing prostate cancer.
In addition, a review found that no study to date has independently identified testosterone replacement therapy as a risk factor for developing prostate cancer. On the contrary, it lists it as beneficial for multiple medical conditions. While it recommends routine prostate screenings, it also emphasizes that TRT is an adequate treatment for men with low T.
A meta-analysis that looked into a total of 1,030 patients on either long-term or short-term TRT, with varying routes of administration, found that regardless of the type of TRT, none contributed to prostate growth — indicating that testosterone did not trigger potential prostate enlargement either.
Make Sure to Get Your Prostate Screened
Since prostate cancer is not uncommon, you should schedule an appointment for a prostate screening with a qualified health provider if you’re over age 45. If you’re of African descent or have a family history of the disease, you should discuss the possibility of getting screened at a younger age.
Regardless of whether you’re taking testosterone or not, you should get your prostate checked routinely for abnormalities and prostate cancer. Because your health is important, schedule a screening visit and take active steps toward good prostate health.
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