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20 April 2011
Testosterone-prostate cancer link questioned
by George Atkinson

The long-standing warning against testosterone therapy in men with untreated or low-risk prostate cancer needs reevaluation, according to a new study in The Journal of Urology.

"It had been believed that a history of prostate cancer, even if treated and cured, was an absolute contraindication to testosterone therapy, due to the belief that testosterone activated prostate cancer growth," said researcher Abraham Morgentaler. "Generations of medical students and residents were taught that providing testosterone to a man with prostate cancer was like pouring gasoline on a fire."

But the new study suggests this traditional view is incorrect, and that testosterone treatment in men does not cause rapid growth of prostate cancer.

Morgentaler, from the Beth Israel Deaconess Medical Center, said that even with a tripling of testosterone concentration neither prostate specific antigen (PSA) concentrations nor prostate volume showed any change in the subjects. Follow-up biopsies of the prostate were performed in all men at approximately yearly intervals, and none developed cancer progression. In fact, 54 percent of the follow-up biopsies revealed no cancer at all. "Clearly, the traditional belief that higher testosterone necessarily leads to rapid prostate cancer growth is incorrect," he noted.

The finding represents a complete shift in thinking from only five years ago. "After seven decades of circumstantial evidence pointing us in the wrong direction, perhaps it is time to consider the once unthinkable - conducting a testosterone therapy trial of sufficient size and duration to determine whether normalization of serum testosterone in older men many reduce the risk of prostate cancer, particularly high-risk prostate cancer," concluded Morgentaler.

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Source: Beth Israel Deaconess Medical Center

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