Testosterone Replacement Therapy in Men with History of Prostate Cancer Found Safe

[Nelson Vergel]

Introduction

Late-onset hypogonadism may impair quality of life and contribute to metabolic and cardiovascular comorbidity in aging men. Testosterone replacement therapy is effective in treating hypogonadism. However, for the millions of men with a history of prostate cancer, exogenous testosterone has long been considered contraindicated, even though little data in such men are available. Clarification of this safety issue could allow treatment to be considered for a sizeable segment of the aging male population.


Aim The aim of this study is to examine population-based utilization and impact of testosterone replacement therapy in men with prostate cancer.


Methods Using linked Surveillance, Epidemiology, and End Results-Medicare data, we identified 149,354 men diagnosed with prostate cancer from 1992 to 2007. Of those, 1,181 (0.79%) men received exogenous testosterone following their cancer diagnosis. We used propensity scoring analysis to examine the effect of testosterone replacement on the use of salvage hormone therapy and overall and prostate cancer-specific mortality.


Main Outcome Measures We assessed overall mortality, cancer-specific mortality, and the use of salvage hormone therapy.


Results Following prostate cancer diagnosis, testosterone replacement was directly related to income and educational status and inversely related to age (all P&#8201;<&#8201;0.001). Men undergoing radical prostatectomy and men with well-differentiated tumors were more likely to receive testosterone (all P&#8201;<&#8201;0.001). On adjusted analysis, testosterone replacement therapy was not associated with overall or cancer-specific mortality or with the use of salvage hormone therapy.


Conclusions In this population-based observational study of testosterone replacement therapy in men with a history of prostate cancer, treatment was not associated with increased overall or cancer-specific mortality. These findings suggest testosterone replacement therapy may be considered in men with a history of prostate cancer, but confirmatory prospective studies are needed.

Source

 

[BigJohn]

Morganthaler's book speaks very clearly about this. There is also a book by a Dr. Friedman that debunks a lot of that.

 

[Dogfather]

I have a psa of 2.6 post-op radical prostatectomy. My Drs are only now concern about my use of Testim/Nandrolone. My psa went from 2.1 to 2.6, and now want advice from a endocrinologist on how to proceed. My surgery was in 07 and I was off testosterone for 4months before having serious side affects. Lupron drove me over the edge with panic attacks etc. So off and on HRT since 2010. I do not make testosterone. My levels drop to below 7 and I can not function. So my Drs have agreed for me to use HRT as a quality of life issue. But now with an increase of my psa everyone is in a panic. Does anyone have advice for me or where to go for current info. I have used HRT since the early 90's and its why I'm alive today. Thanks