Circulating Sex Hormones Play No Role in the Association Between Sexual Activity and the Risk of Prostate Cancer

Ahmadi, Hamed; Allameh, Farzad; Baradaran, Nima; Montaser‐Kouhsari, Laleh; Bazargan‐Hejazi, Shahrzad; Salem, S.; Mehrsai, Abdolrasoul; Pourmand, Gholamreza

doi:10.1111/j.1743-6109.2010.02115.x

Cited by 18 publications

(9 citation statements)

References 50 publications

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“…In 2004, Stattin et al conducted a case-control study of 708 men with CaP and found a modest but significant decrease in CaP risk among men with higher pretreatment testosterone levels (P=0.05) (56). Two similarly designed studies also reported that men with higher testosterone levels had a lower risk of CaP (50,51). A lower risk of biochemical recurrence and better prognosis for both localized and metastatic CaP after radical prostatectomy have also been observed in men with higher pretreatment testosterone levels (52-54).…”

Section: Methodsmentioning

confidence: 89%

Testosterone therapy and prostate cancer

Pastuszak

Rodríguez

Nguyen

et al. 2016

Transl. Androl. Urol.

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The use of exogenous testosterone to treat hypogonadism in the men with a history of prostate cancer (CaP) remains controversial due to fears of cancer recurrence or progression. Due to the detrimental impact of hypogonadism on patient quality of life, recent work has examined the safety of testosterone therapy (TTh) in men with a history of CaP. In this review, we evaluate the literature with regards to the safety of TTh in men with a history of CaP. TTh results in improvements in quality of life with little evidence of biochemical recurrence or progression in men with a history of CaP, or de novo cancer in unaffected men. An insufficient amount of evidence is currently available to truly demonstrate the safe use of TTh in men with low risk CaP. In men with high-risk cancer, more limited data suggest that TTh may be safe, but these findings remain inconclusive. Despite the historic avoidance of TTh in men with a history of CaP, the existing body of evidence largely supports the safe and effective use of testosterone in these men, although additional study is needed before unequivocal safety can be demonstrated.

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Section: Methodsmentioning

confidence: 89%

Testosterone therapy and prostate cancer

Pastuszak

Rodríguez

Nguyen

et al. 2016

Transl. Androl. Urol.

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“…A lively debate on “Is testosterone a friend or foe of the prostate?” in this journal a year ago [28] combined expert opinion with a critical review of the currently available literature and found that there is no conclusive evidence that TRT “increases the risk of PCa or even prostatic hyperplasia.” Also, reassuringly, higher endogenous TT and FT, and factors known to be associated with them such as sexual activity, have been found to be protective against PCa [29].…”

Section: Discussionmentioning

confidence: 97%

Is Testosterone Treatment Good for the Prostate? Study of Safety During Long-Term Treatment

Feneley

Carruthers

2012

The Journal of Sexual Medicine

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Introduction For men with androgen deficiency on testosterone replacement therapy (TRT), clinical concern relates to the development of prostate cancer (PCa). Aim An updated audit of prostate safety from the UK Androgen Study was carried out to analyze the incidence of PCa during long-term TRT. Main Outcome Measures Diagnosis of PCa in men receiving TRT, by serum prostate-specific antigen (PSA) testing and digital rectal examination (DRE), and its relation to different testosterone preparations. Methods One thousand three hundred sixty-five men aged 28–87 (mean 55) years with symptomatic androgen deficiency and receiving TRT have been monitored for up to 20 years. All patients were prescreened for PCa by DRE and PSA along with endocrine, biochemical, hematological, and urinary profiles at baseline and every 6 months. Abnormal findings or rising PSA were investigated by transrectal ultrasound and prostate biopsy. The data were compared for the four different testosterone preparations used in TRT, including pellet implants, Restandol, mesterolone, and Testogel. Results Fourteen new cases of PCa were diagnosed at one case per 212 years treatment, after 2,966 man-years of treatment (one case per 212 years). Time to diagnosis ranged from 1 to 12 years (mean 6.3 years). All tumors were clinically localized and suitable for potentially curative treatment. Initiating testosterone treatment had no statistically significant effect on total PSA, free PSA or free/total PSA ratio, and any initial PSA change had no predictive relationship to subsequent diagnosis of cancer. Conclusions The incidence of PCa during long-term TRT was equivalent to that expected in the general population. This study adds to the considerable weight of evidence that with proper clinical monitoring, testosterone treatment is safe for the prostate and improves early detection of PCa. Testosterone treatment with regular monitoring of the prostate may be safer for the individual than any alternative without surveillance.

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“…42 These findings were supported by 2 subsequent prospective studies of 65 and 194 men that demonstrated a protective effect of higher total testosterone levels against prostate cancer. 4344 A prospective cohort study of 227 patients with median follow-up of 7.7 years showed that increased pretreatment serum testosterone (>11 nmol/l) correlated with a decreased risk of biochemical recurrence after radical prostatectomy. 45 Two studies by Imamoto et al and Yamamoto et al observed that higher pretreatment testosterone levels predict a positive prognosis in patients with metastatic and localized prostate cancer.…”

Section: The Relationship Between Endogenous Testosterone Levels and mentioning

confidence: 99%

Testosterone Therapy Among Prostate Cancer Survivors

Nguyen

Pastuszak

2016

Sexual Medicine Reviews

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Introduction The use of testosterone in men with a history of prostate cancer remains controversial in light of established findings linking androgens to prostate cancer growth. However, hypogonadism significantly impacts quality of life and has negative sequelae, and the risks and benefits of testosterone therapy may be worthwhile to consider in all men, even those with a history of high-risk prostate cancer. Aim To discuss the effects of testosterone on the prostate and the use of testosterone therapy in hypogonadal men with a history of prostate cancer. Methods Review of the literature examining 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. Main Outcome Measures Summary of effects of exogenous and endogenous testosterone on prostate tissue in vitro and in vivo, with a focus on effects in men with a history of prostate cancer. Results Testosterone therapy ameliorates the symptoms of hypogonadism, decreases the risk for its negative sequelae, and can significantly improve quality of life. Recent studies do not support an increased risk for de novo prostate cancer, progression of the disease, or biochemical recurrence in hypogonadal men with a history of non-high risk prostate cancer treated with testosterone therapy. Evidence supporting the use of testosterone in the setting of high risk prostate cancer is less clear. Conclusion Despite the historical reluctance towards use of testosterone therapy in men with a history of prostate cancer, modern evidence suggests that testosterone replacement is a safe and effective treatment option for hypogonadal men with non-high risk prostate cancer. Additional work to definitively demonstrate both efficacy and safety of testosterone therapy in men with prostate cancer is needed, and persistent vigilance and surveillance of treated men remains necessary.

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Circulating Sex Hormones Play No Role in the Association Between Sexual Activity and the Risk of Prostate Cancer

Cited by 18 publications

References 50 publications

Testosterone therapy and prostate cancer

Testosterone therapy and prostate cancer

Is Testosterone Treatment Good for the Prostate? Study of Safety During Long-Term Treatment

Testosterone Therapy Among Prostate Cancer Survivors

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