Long-term hormone replacement won’t raise risk of prostate cancer

The truth about testosterone

I’ve stood behind the safety of testosterone supplementation for years. In fact, it serves as one of the core tenets of my practice.

Long-term hormone replacement is one of the only ways to restore a man’s testosterone levels back to the ideal range. If done properly, it’s not dangerous. And it certainly won’t raise risk of prostate cancer, like some people claim.

And the results of a recent 6-year-long study offer solid proof.

Not that this news should come as a shock to anyone. I mean after all, it makes sense.

If increased testosterone was the cause of prostate cancer, then wouldn’t young men, famous for their raging hormones, get prostate cancer? And why would most men get prostate cancer if they live long enough, anyway?

There are many unanswered questions. But unfortunately, that doesn’t stop medicine from relying on simplistic thinking.

The bias against testosterone replacement comes from the same kind of wrong thinking that led the establishment to think that fat was bad for us and that fiber was good–two other fixations that don’t make any sense. And that have been proven wrong time and time again.

But enough philosophy. Let me shed some light on this new research, so any man taking testosterone–or any man considering it–can now rest easy.

This European study lasted six years and included nearly 200 hypogonadal participants (those with low testosterone).

Interestingly enough, the mean age of the men was 41–not particularly old. (This is something I have been seeing in my patient population as well–younger and younger men needing testosterone replacement. Finding an explanation for this phenomenon would be a good next step, in my opinion.)

All the men received transdermal testosterone via patch. And across the board, the benefits were clear.

For one thing, the subjects’ total Aging Male’s Symptoms (AMS) scores improved. (This is a scale researchers use to measure the effectiveness of androgen replacement therapy.)

Psychological, physical, and sexual wellbeing also improved. In fact, total scores at study’s end were on par with those reported by normal, healthy volunteers.

But that’s not all. While PSA concentrations rose steadily over the course of the study, these increases only became statistically significant after five years. Which is precisely the trend you would expect from a normal aging man.

In other words, testosterone replacement didn’t really affect PSA at all.

More than 90 percent of the patients maintained PSA levels below 2 ng/mL over these six years–well within the range of normal. In fact, only 7 of the men enrolled in this study saw their PSA levels above 4 ng/mL.

In all cases, the cause was prostatitis or infection. And PSA levels returned to normal after treatment.

Most importantly, there were no cases of prostate cancer reported–and very few adverse reactions.

I can’t overstate how important this conclusion is for men’s health. Because the fact is, testosterone replacement isn’t just about restoring sex drive and erectile potency. (Though these are certainly major benefits.)

When men have low testosterone levels–whether due to surgery for prostate cancer or through reasons unknown–they’re at much higher risk of dying from heart disease. They also present with more aggressive prostate cancers than men with normal testosterone levels.

The truth is, testosterone therapy doesn’t cause cancer–but it can save lives. And it can also dramatically boost quality of life for men who have essentially been castrated by conventional medical treatment.

So I’m relieved to see that these researchers are finally setting this particular myth about T replacement straight.

In fact, they went a step further. Based on the results of their study, the authors theorize that normalizing testosterone might even help slow down progression of prostate cancer.

Now that’s thinking I can agree with.

“Prostate-specific antigen (PSA) concentrations in hypogonadal men during 6 years of transdermal testosterone treatment.” BJU Int. 2013 Jan 7. doi: 10.1111/j.1464-410X.2012.11514.x. [Epub ahead of print]