Testosterone therapy and prostate cancer: Risk-benefit and individualized treatment

[madman]

Testosterone therapy and prostate cancer: Risk-benefit and individualized treatment

“The key here is I don’t believe that testosterone increases the risk of prostate cancer progression or biochemical recurrence," says Mohit Khera, MD, MBA, MPH.

www.urologytimes.com

Key Takeaways​

• Testosterone replacement therapy may not increase prostate cancer recurrence risk, but evidence remains inconclusive, necessitating individualized treatment plans.
• Bipolar androgen therapy (BAT) offers a novel approach, potentially inhibiting prostate cancer cell growth through androgen receptor down-regulation and apoptosis induction.
• AUA guidelines emphasize the absence of evidence linking testosterone therapy to prostate cancer development, advocating for informed patient counseling.
• Recent studies show no significant difference in biochemical recurrence rates between testosterone-treated and untreated patients post-radical prostatectomy.

The key here is I don’t believe that testosterone increases the risk of prostate cancer progression or biochemical recurrence," says Mohit Khera, MD, MBA, MPH.


Mohit Khera, MD, MBA, MPH

In this interview, Mohit Khera, MD, MBA, MPH, shares insights on the use of testosterone replacement therapy in men with prostate cancer, touching on current evidence and also stressing the importance of patient counseling and an individualized approach to treatment. Khera is a professor of urology and holds the F. Brantley Scott Chair in Urology at Baylor College of Medicine in Houston, Texas.

Is there anything you would like to add?​

I think that testosterone replacement therapy for [patients with] prostate cancer has to be individualized. It has to be based on numerous factors such as comorbid conditions, life expectancy, Gleason score, pathology, and severity of symptoms. It is important that everyone understands the potential risks and benefits prior to starting [patients] on therapy. Each case should be tailored individually.

 

[madman]

Post in thread 'My results on daily prop 11mg SQ'

Jan 3, 2025

Poor metabolic health is a major risk factor for prostate cancer, which results in high levels of insulin (one of the most potent growth factors for cancer), inflammation, etc.

Triglyceride-glucose index is a predictor of the risk of prostate cancer: a retrospective study based on a transprostatic aspiration biopsy population - PubMed

TyG index and age are risk factors for prostate cancer, and the interaction between the TyG index and different risk factors may increase the risk of prostate cancer. TyG index has some predictive value for the risk of prostate cancer, and the risk of prostate cancer can be reduced by...

pubmed.ncbi.nlm.nih.gov

TRT is not. Men with active prostate cancer are even being treated with TRT now without any adverse effects on progression or mortality:

Oncologic Outcomes of Testosterone Therapy for Men on Active Surveillance for Prostate Cancer: A Population-based Analysis - PMC

In this population-based study, testosterone therapy for men on active surveillance for prostate cancer did not worsen mortality. Keywords: Testosterone, Prostate cancer, Outcomes, Active surveillance

pmc.ncbi.nlm.nih.gov

Look into the saturation model of androgens in the prostate. It takes a very low level of serum testosterone (like serious hypogonadism) to produce intraprostate levels...

• madman

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