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Current Urology Reports

, 19:67 | Cite as

The Role of Testosterone Therapy in the Setting of Prostate Cancer

  • Katherine M. Rodriguez
  • Alexander W. Pastuszak
  • Mohit KheraEmail author
Andrology and Infertility (L Lipshultz, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Andrology and Infertility

Abstract

Purpose of Review

The role of testosterone in the development of prostate cancer and the safety of testosterone therapy (TTh) after prostate cancer treatment, or in the setting of active surveillance, remains controversial. There are many concerns about using TTh in men, particularly those with a history of prostate cancer, ranging from a possible increased risk of cardiovascular disease to cancer progression or recurrence. With many prostate cancer patients living longer, and hypogonadism having significant morbidity, much care must go into the decision to treat. Here, we review the literature investigating the effects of testosterone on the prostate as well as the efficacy and safety of exogenous testosterone in men with a history of prostate cancer.

Recent Findings

The improvement in quality of life with TTh is well studied and understood, while the argument for significantly increased risk of cancer or other adverse effects is much less robust. Neither increased rates of prostate cancer, cancer recurrence, or cardiovascular risk have been well established. In men with high-risk prostate cancer, evidence in the setting of TTh is very limited, and TTh should be used with caution.

Summary

The fears of TTh causing or worsening prostate cancer do not appear to be well supported by available data. Though more studies are needed to definitively determine the safety of TTh in men with prostate cancer, consideration should be given to treatment of hypogonadal men with a history of CaP.

Keywords

Hypogonadism Testosterone Hormone replacement Prostate cancer Prostatectomy Radiation therapy 

Abbreviations

AR

Androgen receptor

DRE

Digital rectal examination

CaP

Prostate cancer

PSA

Prostate-specific antigen

TTh

Testosterone therapy

AS

Active surveillance

Notes

Compliance with Ethical Standards

Conflict of Interest

Katherine Rodriguez, Alexander W. Pastuszak, and Mohit Khera each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Katherine M. Rodriguez
    • 1
  • Alexander W. Pastuszak
    • 2
    • 3
  • Mohit Khera
    • 3
    Email author
  1. 1.Baylor College of MedicineHoustonUSA
  2. 2.Center for Reproductive MedicineBaylor College of MedicineHoustonUSA
  3. 3.Scott Department of UrologyBaylor College of MedicineHoustonUSA

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