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The Cause of Prostate Cancer — Is Testosterone Replacement Therapy a Possible Cause of Prostate Cancer?

The short answer to this question is no, testosterone replacement therapy (TRT) is not a possible cause of prostate cancer.

The cause of prostate cancer is not well understood. hands with blue prostate cancer awareness ribbon

Further, it is highly unlikely that testosterone replacement therapy will make existing cancers worse. There is a growing body of evidence that one of the traditional treatments for prostate cancer, namely, using certain drugs to suppress the natural production of testosterone in your body, doesn’t work for many types of prostate cancers.

In fact, it seems more likely that testosterone replacement therapy may actually improve some of the symptoms of prostate cancer and its treatment.

So where did this belief that testosterone is a cause of prostate cancer (or that it makes prostate cancer worse) come from? According to the study cited above, this long-held belief in the medical community comes from the work of two medical researchers:

“In 1941 Huggins and Hodges reported that marked reductions in T by castration or estrogen treatment caused metastatic pCA to regress, and administration of exogenous T caused pCA to grow. Remarkably, this latter conclusion was based on results from only one patient.”

I want to repeat that last line:

“This latter conclusion [that administration of testosterone caused pCA to grow] was based on results from only one patient.”

You don’t have to be a medical professional to realize the problem with basing your results on a single case.

The Truth Is, We Don’t Really Understand the Cause of Prostate Cancer

What we have instead are a handful of risk factors. We know, for instance, that some inherited genes can increase your risk for prostate cancer. We know that inflammation of the prostate is often associated with prostate cancer, but we don’t know if this is an actual cause.

The unfortunate truth is this: The cause of prostate cancer is largely unknown, and, because we’re discussing cancer, there’s a lot of fear associated with the problem.

That fear often leads medical providers and patients alike to take the “safe” route, to always take more aggressive measures “just to be on the safe side.” The term Cancer can strike fear into the hearts of the bravest men and women out there, so it is understandable that we would want to take every possible precaution.

Yet this isn’t always the best approach. In fact, for some types of prostate cancers (known as slow-growing prostate cancers), trying to be on the safe side may actually be detrimental.

For many men, a “wait and see” approach is appropriate. For these same men, testosterone replacement therapy is unlikely to spur the growth of a hidden or slow-growing prostate cancer. As this article states:

“…if T[estosterone] is “food for a hungry tumor,” then why is the cancer rate only 1% for men receiving TRT when one of seven hypogonadal men has biopsy-detectable pCA?”

Now, for men who have an aggressive or advanced form of prostate cancer, these testosterone reduction strategies may provide benefits.

But, for the majority of men with prostate cancer, it seems unlikely to help:

“The findings echo those of another large, randomized trial carried out in Europe that found that the hormone treatments did not benefit early-stage patients assigned to take them. The drugs only improved survival only in men with a more aggressive form of the disease.”

Reducing or Eliminating Your Testosterone Can Be Detrimental, but Testosterone Replacement Therapy May Alleviate Symptoms

Testosterone replacement therapy certainly isn’t the cause of prostate cancer. If you have a slow-growing form of prostate cancer, eliminating your testosterone through chemical means is probably not the best way to go, though you should always rely on your medical provider as the final say.

However, if you also suffer from low testosterone, testosterone replacement therapy may be beneficial. We may never know the exact cause of prostate cancer, but we might be able to treat some of the more damaging side effects.

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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