Does Testosterone Therapy Cause Prostate Cancer?

November 16, 2023

Is There a Link Between TRT and Prostate Cancer?

The relationship between testosterone and prostate cancer is a complex one. According to the American Urological Association, elevated levels of testosterone aren’t directly linked to causing prostate cancer however the growth of existing prostate cancer cells can be influenced by hormones, including testosterone.

It is essential to consult with a healthcare professional for personalized advice based on your health and medical history and receive proper testing prior to starting TRT. One test that should be performed and is minimally invasive is a PSA blood test. Prostate-specific antigen (PSA) is a protein produced by both normal and cancerous cells in the prostate gland. The PSA test assesses the PSA levels in the bloodstream, involving the analysis of a blood sample in a laboratory. Results are typically presented as nanograms of PSA per milliliter (ng/mL) of blood.

Elevated PSA levels are often associated with prostate cancer. Initially, the FDA approved the PSA test in 1986 for monitoring the progression of prostate cancer in diagnosed individuals. Subsequently, in 1994, the FDA expanded approval to include the use of the PSA test alongside a digital rectal exam (DRE) to assist in detecting prostate cancer in men aged 50 and older.
Until around 2008, there was a widespread recommendation among many doctors and professional organizations for annual PSA screening for prostate cancer, commencing at age 50.

According to the American Association of Urology

“Clinicians should inform patients of the absence of evidence linking testosterone therapy to the development of prostate cancer.”
“There is accumulating evidence against a link between testosterone therapy and prostate cancer development. Randomized controlled trials have shown that there is not a significant increase in the rate of a prostate cancer diagnosis in older, testosterone deficient men who were treated with testosterone compared to placebo”

What is The Prostate?

The prostate is a small gland in the male reproductive system, located right under the bladder and just in front of the rectum. It surrounds the male’s urethra, which is the tube that carries urine from the bladder out of the body through the penis. The primary function of the prostate is to produce a fluid that, along with sperm from the testes and fluids from other glands, produces semen.

What are The Symptoms Associated with Prostate Cancer?
Prostate cancer may not cause noticeable symptoms at first. In its preliminary stages, its hard for most people to detect which is why screening is important especially for those with a family history of prostate cancer. As it progresses, some signs and symptoms can include:

1. Urinary Changes: Difficulty starting or stopping urinating, or having a weak or interrupted flow, frequently needing to pee (especially during the night) or having a feeling of incomplete emptying of the bladder are all potential signs.

2. Blood in the Urine or Semen: It is possible for blood to be present in the urine or semen.

3. Erectile Dysfunction: Difficulty in achieving and/or maintaining an erection.

4. Pain and Discomfort: Discomfort in the pelvic region, in the lower back, or even in the upper thighs. In the advanced stages, prostate cancer may spread to the bones, which causes pain.

5. Weight Loss and Fatigue: Unexplained weight loss and persistent fatigue are also possible indicators.

It is important to note that these symptoms may also be caused by medical conditions other than prostate cancer. If an individual experiences any concerning symptoms, it's also important to consult with your doctor or a healthcare professional, such as a urologist or oncologist for proper evaluation and diagnosis. Regular medical check-ups and screenings are vital, especially for those at higher risk.

What Treatments Are There for Prostate Cancer?
Treatments for prostate cancer will depend on different factors, which will include what stage of cancer they are in and the patients overall health. Common treatments can include surgery, radiation therapy, hormone therapy, chemotherapy, immunotherapy, and active surveillance (monitoring without immediate medical intervention). The choice of treatment is often a collaborative decision between the patient and medical team composed of various doctors and healthcare specialists. It's vital to consult with experienced medical professionals to determine the best approach for an individual's specific situation to determine the appropriate care and action plan.

What is Hormone Therapy for Prostate Cancer Patients?

Hormone therapy for men diagnosed with prostate cancer often involves reducing levels of androgens, like testosterone, which can speed up the growth of prostate cancer cells. Testosterone will not directly cause prostate cancer but the presence of testosterone can accelerate its advancement. There are medications called anti-androgens or gonadotropin-releasing hormone (GnRH) agonists which can block testosterone and slow the growth of the cancer within the prostate. These medications work by either blocking the production of androgens (testosterone) or inhibiting their effects. Hormone therapy is a fairly common approach for patients, especially those with advanced prostate cancer, and can be used either alone or in combination with other treatments depending on the individual patient’s specific situation. The specific regimen depends on the individual's condition and the recommendation of their physician and medical team.

How Can You Tell if You Have Prostate Cancer?  

Prostate cancer can be detected through a few different methods:

1. Digital Rectal Exam (DRE): A doctor will insert a gloved, lubricated finger into the patient’s rectum to feel the prostate for any abnormalities and if its larger than normal.

2. Prostate-Specific Antigen (PSA) Test: This blood test, as stated before is minimally invasive and measures the level of PSA, a protein produced by the prostate. Elevated PSA levels may indicate prostate issues, but it is not specific to cancer. PSA levels can change over time and should be a routine part of your bloodwork to get a baseline and help determine and changes which could help with early detection.

3. Biopsy: If there are abnormalities detected through one of the previously mentioned methods, like a DRE or elevated PSA levels, a biopsy may be performed by the physician. A biopsy is when small tissue samples are taken from the prostate and then examined under a microscope to determine if cancer cells are present.

4. Imaging Studies: Advanced imaging techniques, such as MRI or CT scans, can be used to evaluate the extent of the cancer and whether it has spread.

Regular screenings and discussions with a healthcare provider about the benefits and risks of testing are crucial, especially for individuals with risk factors or symptoms and older male patients. The average age of a patient when diagnosed is 66 years old, however it can happen to anyone at any time. It is essential to consult with a healthcare professional for personalized advice based on individual health and circumstances as early detection is the best way to combat this disease.

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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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