Many men with low testosterone find themselves apprehensive about undergoing testosterone replacement therapy (TRT). The commonly held theory is that high levels of testosterone stimulate the growth of prostate cancer.
New findings show that TRT has very little impact on the growth of prostate cancer or the elevation of PSA levels and may change the way you think about the efficacy of testosterone in cancer treatment.
What is Testosterone Replacement Therapy (TRT)?
Testosterone is a steroid hormone (androgen). It is produced mainly in the testes and is crucial to male sexual development.
TRT is a therapy designed to combat the effects of hypogonadism, a condition in which the testes produce little testosterone – in men. This hormone treatment involves administering doses of T through either gels, creams, or injections.
Testosterone and the Prostate
According to an article published by the James Buchanan Brady Urological Institute at Johns Hopkins, testosterone is one component of a “furnace” of events in the body, set off by prostate cancer.
When the prostate is removed during a radical prostatectomy, a luteinizing hormone (LH) and testosterone are increased. This hormone is found in the pituitary gland, which acts as a regulator controlling the testes. It is this process that Johns Hopkins refers to as a “furnace.”
In this case, the pituitary gland is the thermostat, the testes are the furnace, and testosterone is the heat. This heat stimulates the prostate, which simultaneously regulates its own release of the luteinizing hormone.
Basically, testosterone causes the prostate to grow, which can lead to diseases such as prostatitis or benign prostatic hyperplasia. But it may not cause cancer cells to grow. Urology Times reports that there are no links between TRT and prostate cancer. According to a study originally published by Trends in Urology and Men’s Health, men who had undergone testosterone replacement therapy experienced little to no changes in their PSA levels. The study states that developing prostate cancer during TRT is rare but can be effectively treated.
Urology Times is one of several studies that have found no link between TRT and prostate cancer.
So, if there is no link between the introduction of higher levels of testosterone in men, as part of TRT, and prostate cancer, then how did we come to the conclusion that testosterone was a key factor in the disease’s development?
The Myth of Prostate Cancer and Testosterone
A 2008 report published in Life Extension Magazine tells the story of how testosterone became associated with the presence of cancer.
In 1941, Charles B. Huggins, a urologist at the University of Chicago, was studying benign prostatic hyperplasia in dogs and discovered that the cancer in their prostates had several similarities to human prostate cancer. He also found that their prostates shrunk after castration, and no more cancer could be detected.
Huggins decided to apply the same methods to humans by reducing their testosterone levels, which was a key effect in castration. He measured his results using an acid phosphatase blood test, which had delivered high results in men with metastatic cancer, or cancer that had spread beyond the prostate.
After administering the test to his subjects, Huggins found that after reducing testosterone in men with prostate cancer, the acid phosphatase was reduced. He also found the converse to be true: according to Huggins’ experiment, when administered to men with prostate cancer, testosterone injections raised acid phosphatase. Thus, the conclusion that increased testosterone causes prostate cancer to increase.
The Truth About T
While groundbreaking, there are a few problems with Huggins’ experiment, namely, its shaky foundations. According to the Life Extension Magazine article, acid phosphatase is an extremely erratic and unreliable test, which throws Huggins’ results into question.
The truth about testosterone isn’t as cut-and-dry as Huggins and his experiment made it out to be. It is true that androgen deprivation therapy (ADT) – used to prevent testosterone from reaching prostate cancer cells – has helped shrink and slow the growth of prostate cancer in men with more advanced cancers and can improve their survival rates.
However, it may not be necessary for men with low grade cancers. MedScape reports that testosterone suppression does not necessarily give men a survival advantage. This is corroborated by a New York Times article, which states that there is “no compelling evidence” to use ADT drugs in older males with slow-growing cancer and, in some cases, they can cause heart disease and diabetes.
Huggins’ experiment also doesn’t take into account the fact that prostate cancer incidences increase – and testosterone decreases – with age. In fact, low testosterone can be bad for those with newly diagnosed cancer. Medscape reports that low pretreatment serum testosterone levels can mean a higher stage cancer and a shorter time to disease progression.
The truth about testosterone is that testosterone levels alone are not accurate predictors of cancer. Age, race, weight, and medical history are all factors that should be considered when predicting prostate cancer.
The Benefits of Testosterone Replacement Therapy
Although testosterone is not a reliable indicator of the presence of cancer, low testosterone has other problems that should not be ignored.
Testosterone deficiency syndrome (TDS) can cause depression, fatigue, erectile dysfunction, and decreased muscles mass in males. Despite its correlation to the presence of aggressive cancer, low testosterone is not always cancer-related.
Low testosterone can be a side effect of certain medications, diabetes, thyroid disorders, stress, fatigue, or a hormonal imbalance.
Men who have undergone testosterone replacement therapy have experienced an increase in bone density, improved muscle mass, increased libidos and improved moods. According to MedScape, it is also possible that TRT normalizes prostate growth by balancing the underdeveloped gland.
Testosterone replacement therapy is not for everyone, but it is no longer something to be feared as a cancer trigger. Although more research is still being conducted on the subject, TRT’s benefits for men with low testosterone levels make it an option worth considering.
If you have low testosterone and are considering testosterone replacement therapy, talk to your doctor to see if it is the right treatment for you.
And if you’re considering purchasing life insurance after prostate cancer, talk with us! Let’s get started!