Testosterone replacement can be dangerous for people with prostate cancer. When using it, it must be used with caution. For some high-risk groups, it increases the risk of prostate cancer recurrence.
Testosterone replacement therapy is considered safe for people who are at low risk of relapse, are adequately treated, and are considered to be in remission.
Testosterone laboratory blood test
A blood test is one factor used to determine if testosterone needs to be replaced. If you have your testosterone levels checked by a home test or lab as ordered by your doctor, your results may not be definitive.
Problems affecting testosterone blood levels:
- Testosterone blood levels are higher in the morning and lower at night. A “low” test at 4 p.m. may just be outside the normal range due to different blood collection times.
- There are two types of testosterone tests: total testosterone and free testosterone. Most routine tests measure only total testosterone. However, free testosterone is a more accurate measure of the physiological activity of testosterone.
Determining whether you need testosterone therapy isn’t just based on testosterone levels in your blood. It’s also important to consider your symptoms and whether they indicate low testosterone levels.
Should older men take testosterone supplements?
Testosterone Therapy and Prostate Cancer
Testosterone therapy may increase the risk of prostate cancer recurrence in some people.
Some factors that are particularly associated with a high risk of recurrence:
- Extraprostatic extension (cancer spread outside the prostate)
- positive margin
- positive node
- Biopsy Gleason score of 8 or higher
- Violation of seminal vesicles
In some cases, testosterone treatment is not harmful and may be beneficial for people with prostate cancer.
- men with low-grade or benign tumors
- Men who have had surgery or radiation therapy and appear to be cured can use testosterone therapy after an appropriate waiting period of two to five years. The risk of cancer recurrence at this time is usually low.
- This was associated with marked weakness when men with known prostate cancer had low testosterone levels, severe physical weakness, or very severe muscle loss.
Why the confusion?
Because prostate cancer is not a single disease, there has been confusion about the use of testosterone therapy in men with known prostate cancer.
- Low, medium and advanced forms
- Localized disease and metastatic cancer
- Hormone-sensitive types and types that are not sensitive to hormone therapy
A single regimen will not universally work for every type of prostate cancer.
Testosterone Therapy Management and Risks
Testosterone therapy comes in different formulations, including short- or long-acting injections, creams, gels, and transdermal patches.
There are differences in the way men respond to testosterone therapy. For some people, the effects of testosterone replacement are immediate and significant. In other men, there may be a lack of clear benefit even after an adequate six-month trial period.
The only way to know for sure if you will benefit from testosterone is to give it an adequate trial period.
Testosterone replacement increases the risk of blood clots. Long-term testosterone replacement therapy is associated with an increased risk of cardiovascular problems, including heart attack and stroke, especially in older men.