Testosterone replacement therapy may raise prostate cancer risk

Fooling Mother Nature can sometimes make you feel better. But there’s often a price to pay.

In the e-Alert “The Other Pause” (4/28/05), I told you about the growing use of testosterone replacement therapy (TRT) to treat symptoms of andropause (the male counterpart of menopause).

As men grow older, their testosterone levels drop a little more than one percent each year after the age of 40. This change can trigger moodiness, memory loss, a decline in sex drive, and a lack of energy, strength and endurance. Taken together, these conditions sometimes cause men to experience a gradual passivity and disinterest in life.

Several years ago the FDA approved TRT for the treatment of low testosterone production called hypogonadism. Since then, many doctors have exercised the option of off-label usage to prescribe the therapy for other andropause symptoms. The upside: Many men who use TRT report a boost of energy and libido. The downside: some studies have shown that TRT may raise prostate cancer risk.

A new study from the University of California has confirmed that risk. And although it’s a small observational study of only 20 men, it points up the fact that doctors and their older male patients must be very cautious with this therapy.

As reported in the current issue of the Journal of Urology, seven of the subjects were diagnosed with prostate cancer within the first year of treatment, four more were diagnosed the following year, and the rest were diagnosed over the course of eight years.

One of the researchers, Franklin D Gaylis, M.D., told Reuters Health that men who consider using TRT should receive “careful, informed consultation regarding the risks and benefits of such a treatment.” And this is especially true of any man who has a family history of prostate cancer.

“Testosterone Treatment Linked with Prostate Cancer” Will Boggs, M.D., Reuters Health, 8/12/05, reutershealth.com