Testosterone Replacement Therapies and Prostate Cancer

Understanding hormone therapy options

Prostate cancer is the second most common type of cancer among men, with skin cancer being the first. High-dose testosterone replacement therapies have been found to help in some cases of advanced prostate cancer. However, the most common type of treatment for prostate cancer continues to be hormone suppression treatments, which have been in use for a while. After successful prostate cancer treatments, you may want to receive testosterone replacement therapy. There are some concerns to this, with regards to whether or not testosterone replacement is helpful or harmful after prostate cancer treatment. The science on these issues is continuing to progress, attempting to find out just what type of impact testosterone replacement has on post-prostate cancer recipients.

High-Dosage Testosterone as a Treatment For Prostate Cancer

A new study conducted by researchers at Johns Hopkins Hospital found that there was a possibility that high dosages of testosterone could help treat certain forms of prostate cancer. Testosterone fuels prostate tumors, so the thought of treating this cancer with more testosterone was viewed very skeptically by the medical community. Johns Hopkins’ researchers, in a trial involving sixteen men with prostate cancer that was resistant to castration, found that high doses of testosterone could be linked to the disease waning. Fourteen out of the sixteen men in the trial finished their therapy, and the majority of their cancer seemed to be showing signs that the disease was retreating. Several became newly sensitized to castrating drugs, which were used to treat their prostate cancer but had become ineffectual. The castration drugs began to work again after these high doses of testosterone.

Although this was a small clinical trial, it held promising results for patients looking for other ways to treat their prostate cancer besides hormone suppression therapies, which reduce testosterone levels and can have unpleasant side effects as a result. The main takeaway from the Johns Hopkins study was that the prostate cancer, when exposed to high dosages of testosterone replacement, did not grow any worse and, in many of the cases, it even showed signs of improvement. That casts a hopeful light onto further attempts to find alternatives to hormone suppression.

Testosterone Replacement After a Successful Prostate Cancer Treatment

This issue—whether or not testosterone replacement after surviving prostate cancer is acceptable—is hotly debated. For a long time, there has been a strict “prohibition” on testosterone treatment after prostate cancer. Testosterone plays a role in the development of this cancer and, logically, it could be inferred that further doses of the hormone would only cause the cancer to worsen or, in the case of those who had beaten the cancer, return.

However, that perception has changed slightly. Some experts have pointed out that men experience declines in their testosterone levels as they age, but also develop prostate cancer as they get older. If they are developing this disease as their testosterone rate drops, some argue, then how can testosterone be responsible for it? Doctors such as Harvard Medical School’s Abraham Morgentaler, M.D. also have called on the medical community to look at the benefits that increasing testosterone has on men’s mood, libido, and energy level.

On the other side of the debate are cautious doctors who don’t want to take the risk of the testosterone replacement “reawakening” dormant cancer cells and potentially leading to a return of the disease. The FDA seems to agree with this, as it requires testosterone products to contain a label that says that testosterone therapy is “contraindicated” in men who have previously had prostate cancer.

Studies have shown that men that have had prostatectomies (prostate removals) did not show a reoccurrence of the cancer after they were given testosterone replacement. These studies, conducted by Case Western Reserve School of Medicine and Baylor College of Medicine, treated men with testosterone therapy and then followed them for a lengthy follow-up time (in one of the studies, the follow-up time was twelve years) to see if they redeveloped the cancer. The researchers found that there was no reoccurrence of the prostate cancer after the testosterone replacement therapies.

A middle-ground that the medical community seems to be coming towards is that of caution: if you’re going to give patients testosterone replacement therapies after successful prostate cancer treatments, it should be done slowly and gradually, so that there is a chance to stop the treatment immediately if a reoccurrence of cancer is shown. During this time, more studies are being conducted on patients who have not had their prostates removed to see if they, too, do not show signs of returning cancer when receiving testosterone treatments.

A successful prostate cancer treatment is excellent, but it will likely leave your testosterone levels depleted. Low testosterone can cause fatigue, erectile dysfunction, low libido, irritability, mood swings, and more. Because of these side effects, doctors and medical researchers are doing everything they can to make the science of post-prostate-cancer testosterone replacement therapy more definitive, clear, and accessible.