Testosterone Therapy For Prostate Patients

Somewhere along the line, and for a long time since, a notion arose that men with prostate cancer shouldn't undertake testosterone therapy. The popular perspective was that such therapy could “feed” the cancer, making it more aggressive.

Happily, researchers at the University of British Columbia in Vancouver, Canada, have finally debunked this theory.

About 3.1 percent of men younger than age 70, and 18.4 percent of men older than 70, experience the condition known as “hypogonadism” – low testosterone. The solution in most cases is an administration of testosterone from outside sources, either via injection or through skin creams, patches, gels, or subcutaneous pellets. It's an established and effective treatment. But fears of what effect the treatment would have on prostate cancer sufferers usually prevented these patients with hypogonadism to enjoy its benefits.

The team from UBC examined electronic medical records at the Vancouver Prostate Center at Vancouver General Hospital and the Victoria General Hospital. They found 82 hypogonadal men with prostate cancer who had been treated with testosterone therapy. The group was a mix of men who had been treated with radical prostatectomy, radiation therapy, cryotherapy, and high intensity focused ultrasound. Eight of the patients were on active surveillance.

What the researchers learned was that, although the patients' protein specific antigen (PSA) level climbed following the testosterone therapy, their Gleason scores did not.

The Gleason Scale is a metric for measuring patterns of a prostate cancer tumor, and judging how severe they are. A pathologist examines the patterns of a tumor and notes how close that pattern resembles certain stock patterns. These reference cell images – Gleason patterns – range from “Pattern 1” at which level the cells more closely resemble normal prostate cells, to “Pattern 5,” in which the tissue does not have any or only just a few recognizable glands.

The researchers concluded that, “In the absence of randomized, placebo controlled trials, our study supports the hypothesis that testosterone therapy may be oncologically safe in hypogonadal men after definitive treatment or in those on active surveillance for prostate cancer.”

They published their results in The Journal of Urology.