The Relationship between Total Testosterone Levels and Prostate Cancer: A Review of the Continuing Controversy

Abstract

The relationship between total testosterone and prostate cancer has been an area of interest among physicians for decades. Conflicting results have been reported on the relationship between total testosterone and subsequent prostate cancer. Much of this controversy appears to be based on conflicting study designs, definitions and methodologies. To date no prospective study with sufficient power has been published to unequivocally resolve the issue. The preponderance of studies of the safety of exogenous testosterone in men with a prostate cancer history suggests that there is little if any risk. However, because the risk has not proved to be zero, the most prudent course is to follow such men with regular prostate specific antigen measurements and digital rectal examinations.

Factors associated with testosterone recovery after androgen deprivation therapy in patients with prostate cancer

“…Prostate cancer is one of the most common cancers in men [1]. Androgen deprivation therapy (ADT) is a mainstay…”

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

“…High testosterone levels were previously considered to lead to the potential development of PCa and more rapid growth of the tumor (9,10). However, studies on the association between testosterone and PCa risk have produced conflicting results (8,9).…”

“…High testosterone levels were previously considered to lead to the potential development of PCa and more rapid growth of the tumor (9,10). However, studies on the association between testosterone and PCa risk have produced conflicting results (8,9). Numerous studies have demonstrated that low, rather than high, testosterone levels at diagnosis were associated with various markers of poor prognosis, including an advanced pathological stage, higher Gleason scores, higher PSA levels, seminal vesicle invasion and positive surgical margins (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

A critical analysis of the 2014 CUA guidelines for erectile dysfunction: Is there more that can be done?

“…13 While most assuredly an indication for specialist referral, the concept of prostate cancer being an absolute contraindication to TST is currently being challenged. 14 Indeed, most of the current evidence suggests that it is reasonable to offer TST to a selected group of individuals with a history of prostate cancer. 14,15 In summary, the current guidelines offer an excellent synopsis for the management of ED patients.…”

“…14 Indeed, most of the current evidence suggests that it is reasonable to offer TST to a selected group of individuals with a history of prostate cancer. 14,15 In summary, the current guidelines offer an excellent synopsis for the management of ED patients. Subtle intricacies and variable treatment options exist beyond the scope of the guidelines.…”