Have any questions? 888.828.4300info@tctmed.com

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888.828.4300info@tctmed.com

Testosterone and Prostate Cancer — The Real Story

Testosterone and prostate cancer have long been linked, and when I say long I mean since the 1940’s.

testosterone and prostate cancer

This myth that testosterone therapy somehow increases the risk for prostate cancer has lingered for years, despite the growing body of evidence to suggest otherwise (see this article from European Urology and this article from the New York Times to learn more).

Although some people will still try to argue that testosterone can somehow increase the risk of prostate cancer, most experts will agree that testosterone in and of itself does not cause prostate cancer, or any other form of cancer for that matter.

In fact some studies have suggested the exact opposite by demonstrating that men with chronically low levels of testosterone have a higher predilection towards developing the disease relative to men with normal T levels.

It should also be noted that the goal of testosterone treatment at TCT is to simply normalize your T level, 24 hours a day, 7 days a week.

Unfortunately, one does not simply reverse a decades-old myth in an instant. There are many other sources out there who still push the idea that testosterone increases the risk of prostate cancer and as a result, some people become forced to live with the lifelong consequences of Low T.

These outdated methods and mindsets are the result of ingrained practices, fear and ways of thinking that are too deeply entrenched to be changed. But even if all this were true (the data is inconclusive at best), testosterone therapy has potential benefit when it comes to the detection of cancer.

Testosterone Therapy Can Actually Help Detect Prostate Cancer

When it comes to testosterone and prostate cancer, one of the greatest benefits of testosterone therapy for low T is that, here at Testosterone Centers of Texas, we routinely check for various abnormalities in your blood.

We check levels prior to beginning treatment and on a routine basis concurrent with TRT. In fact, we check them so regularly that we can find evidence of an abnormality much sooner than it otherwise may have been detected!

In order to properly manage your testosterone levels, we do blood work at scheduled intervals (typically every 90 days) to make sure that your testosterone levels are not too high or too low.

We do this because as opposed to what you may have been lead to believe in the past, there is no “one size fits all” when it comes to testosterone dosing. We simply determine that your current dose is resulting in normal testosterone levels; i.e. it’s not too high or too low, but just right.

While we are checking your testosterone levels, we are also looking a variety of other lab panels to ensure that your body is agreeing with your maintenance dose of testosterone. Another way to say that is we want to ensure everything is well tolerated on a biochemical level.

One of the most routine tests we perform is PSA (Prostate Specific Antigen). While there is clearly room for concern for an abnormal PSA level at the beginning of treatment, we pay very close attention to how your PSA level behaves over the course of therapy. This is called a PSA Velocity or a change in your PSA from x to y over a set period of time.

This is because there may be an association between higher levels of testosterone, which you would experience on treatment, and accelerated growth of an existing cancer in the prostate. To be clear, the data is inconclusive and has not nailed down a definitive relationship however we have seen a handful of these cases clinically.

The key factor to take away from this is that had these men not initiated TRT and not underwent regular testing of their PSA level, these cancers may have went undetected for years.

As you’re probably aware, early detection is paramount in improving one’s odds of beating practically any type of existing malignancy. Across the board, our patients were grateful that they made the decision to start testosterone therapy because it lead to early detection of a cancer that they didn’t know they had and in turn, may have added years to their lives.

Testosterone Therapy Is Part of a Good Preventative Health Plan

The best treatment for any disease is to prevent if from happening in the first place and while this usually begins with risk factor modification, it certainly doesn’t end there.

We think oftentimes our genes (heredity) can play a role in predisposing one to various forms of disease and the same can be said for prostate cancer. The best evidence-based medicine we have to date suggests that testosterone and prostate cancer are not definitively linked.

It should be stated however that the potential for early detection of prostate cancer is by no means a reason to start testosterone therapy.

But you should know that testosterone treatment at Testosterone Centers of Texas may not only help you squash the symptoms of low T in the here and now, but if managed appropriately, may contribute to numerous beneficial effects to your health over the years to come; some of which are clearly known and some of which may be incidental.

Either way, a healthier, happier you is what we’re all about.

If you think it’s time to start testosterone therapy, if you think you’re struggling with low T, and if you’re ready to take the next step in forming your own preventative health plan, click to the button below to schedule a free consultation.

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LOW T RESOURCES

(Bill) William J. White, PA-C

(Bill) William J. White, PA-C brings over 20 years of surgical experience to our practice. He is a decorated veteran of the United States Army where he served for nearly 6 years with duty assignments, both here and abroad.   During his military career, Bill was trained as a Certified Surgical Technologist, and following an Honorable Discharge from the Army, he attended Texas Tech University.   He graduated with a Bachelor of Science in Biology and went on to attend PA School at the University of Texas Southwestern Medical Center at Dallas. He spent the first 10 years of his career in Neurosurgery.

24 Comments

  1. Brian on 10/21/2015 at 11:33 am

    I had my prostate removed 8 years ago at age 60. My tsterone level is 30.2 and my PSA level was 0.42 have I need to worry my doctor says its very rare for man of 68 to have this level
    Thank you for your thoughts.

    • Augie Galindo on 10/21/2015 at 2:13 pm

      Brian,

      Using our the generally accepted ranges that I see (normal being 300-1000 ng/dl), your level would be extremely low. This, however, becomes a quandry. A history of prostate cancer is generally considered a contraindication to therapy. Some clinicians are choosing to treat despite this fact, but it does increase your chances of “activating” metastatic growth.

      Best regards,
      Augie Galindo, PA-C
      Founding Partner – Testosterone Centers of Texas

  2. John on 06/18/2016 at 4:08 pm

    I am currently on active surveillance for prostate cancer. I am 55 years old and was diagnosed two years ago- at the time my biggest symptom was extreme fatigue, and they found my testosterone was very low. I recently had my cancer screening labs and my PSA was 5.08 and my testosterone was 243. Not surprising since I am again having a lot of fatigue. My question is this ..IF i did testosterone therapy to bring my levels into a normal range for a man my age- would I be taking a chance on my cancer growing? I currently have a gleason score of ( 3+3) 6 – and after two biopsies have been told its low risk prostate cancer. However my energy levels make it difficult to get through a normal work day- and I am contemplating doing the therapy- but not at the risk my Cancer could grow.

    • Augie Galindo on 06/20/2016 at 3:59 pm

      John,

      Unfortunately, I don’t think that it would just be a “risk”, John. I believe it would be a certainty. Most prostate cancers are androgen dependent. Follow the advice of your urologist and your better judgment, but I never recommend therapy if there is present or previous prostate cancer that hasn’t been treated with complete resection of the prostate and confirmed remission with a stable and non-detectable PSA.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  3. Bob Phillips on 06/30/2016 at 11:00 am

    I am an 83 year old male. I’ve been physically active (running, lifting light
    weights, eating properly) all of my adult life. I am concerned about the shrinkage of my bones.

    I took Nexium for years and assumed that was the cause. Now I’m wondering
    re: the possibility that my bone shrinking is made worse by low T. If so, would
    I be helped by testosterone supplementation. If so, would drugs encourage
    growth of cancer. I’ve had two TURPs and have very little left of my prostate.

    • Augie Galindo on 07/12/2016 at 11:03 pm

      Bob,

      The only way to know is to visit an experienced TRT provider and have a history and physical performed with lab work. Testosterone does not promote cancer growth, however, if you have an undiagnosed prostate cancer and then start TRT, it will grow more aggressively. As we age, the risks increase.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Bob Phillips on 07/13/2016 at 10:16 am

        Thanks very much for the feedback.

  4. PHILIP KIME on 07/23/2016 at 8:23 am

    I have had prostate cancer in 2014,I had the radiation where you get into a machine and they zap you with radiation for 42 visits.I am very fatigued,have congestive heart failure i think by very low T levels.my urologist says no testosterone treatment.I feel that I am on my last leg at 70 years old next month.QUESTION,could I take testosterone treatment seeing I had radiation treatment? psa # very low and staying there.

    • Augie Galindo on 07/28/2016 at 3:32 pm

      Philip,

      It is still unadvised. The likelihood of you having a dormant remnant of prostate cancer remains high, and testosterone would only cause it to grow and spread more aggressively. As unfortunate as it is, I think you are receiving the right advice.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  5. Edward Sohi on 07/31/2016 at 7:46 am

    Hi, I’m 67 years old and still sexually active. I see a rapid decline in my T level, which I assume it’s normal with aging, though surprisingly my libido level is quite high. So far, no strange prostate performance, except waking up couple of times during the night and a short pain in prostate area, every 4-6 months. I wonder if I’m a candidate for T therapy to increase my T-level?

    • Augie Galindo on 08/02/2016 at 9:38 am

      Edward,

      A very slow, and slight decline in testosterone is definitely normal with aging, but a rapid decline is not. The best way to determine candidacy for treatment is to be evaluated by an experienced TRT provider and have your levels formally checked and weighed against your individual potential risks and benefits.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  6. Concerned Dad on 08/03/2016 at 2:06 pm

    My son (age 25) has low T. The last three blood work reports (Dates: 6/23/14, 2/25/16, & 6/20/16) provide the following data: T Serum – (470, 203, 219) ng/dL; Free T – (13.8, 11.4, 4.2) pg/mL; Estradiol – (–, –, 14) pg/mL; Cortisol Serum – (–, –, 6.5) ug/dL; Prolactin Serum – (–, –, 7.6) ng/mL; T4 Free – (1.25, –, 1.27) ng/dL; TSH – (1.07, 1.31, 1.98) uIU/mL; LH – (–, –, 3.9) mIU/mL; FSH – (–, –, 4.3) mIU/mL; ACTH – (–, –, 18) pg/mL; Vitamin D – (–, –, 37.8) ng/mL; and B-12 – (–, >1610, 1608) pg/mL. I also notice an gradual increase in the following: WBC (7, 7.4, 8.1); RBC (5.23, 5.6, 5.73); Hemoglobin (15.5, 16, 16.5); Hematocrit (43.7, 46.1, 46.5); RDW-CV (12.3, 12.4, 13.5); and Platelets (209, 238, 241). He recently went to an Endocrinologist and has prescribed Androgel. Does this sound like the correct treatment or are these numbers telling us to look deeper?

    Concerned Dad

    • Augie Galindo on 08/04/2016 at 11:08 am

      Concerned Dad,

      That is certainly a plausible option. I strongly prefer injections over topicals, but compliance with and skillful management of care is really what matters most.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  7. Paul on 08/08/2016 at 8:39 am

    I was diagnosed with prostate cancer on 11/2015.I had my entire prostate ablated 3/2016. Procedure went well my PSA is now 0.176 and my second post procedure PSA was 0.224. However I have been plagued with fatigue and weight gain. It turns out my B12, Vitamin are low. As well as my T score (145). I’m 53 my libido is in the hole too. Thinking about pellet implant. For Love of Pete I got married Dec 27,2016.

    • Augie Galindo on 08/22/2016 at 1:52 pm

      Paul,

      I can absolutely see why you are seeking treatment. And, I do believe that TRT will benefit you, as long as your risk for recurrent malignancy is properly assessed and mitigated. I would recommend following up closely with urology/oncology until they give clearance for TRT. Furthermore, when the time is right, I would strongly recommend against pellets in your case. Should testosterone pose a threat to the activation of latent metastases, the last treatment you should utilize would be one that attempts to give you 6 months worth of medication at one time without a way to “turn it off” should that become necessary.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  8. Amarjit Sahay on 10/07/2016 at 9:10 am

    I had prostrate cancer detected in Nov 2013 – PSA 20 Gleason 3+3 = 6. Had cyber knife treatment in April 2014. PSA level came down to 0.24 and remained below 0.5 till Nov 2015. In Jan 2016 it was 0.87, April 1.20 and August 2.05.. PSA increased rapidly during 2016. Oncologist advised that I should get a PSMA pet scan done. Result showed that the cancer was back and had reached the lymph nodes. Oncologist advised to wait and watch or to start hormone injections. If decision was to wait and watch then to get PSA done every 2 months. Oncologist also asked me to get lab results for free and total testosterone levels. These are T total 189.06 ng/dl. T free 1.75 pg/ml. % free testosterone 0.09 %.
    Is low testosterone levels bad news? What should I do? – wait and watch or start hormone treatment and/or take some treatment for low T levels or some thing else?

    • Augie Galindo on 10/10/2016 at 4:23 pm

      Mr. Sahay,

      I never recommend TRT for patients whose prostate cancer is still in the early stages of surveillance.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  9. Bob Mantione on 10/12/2016 at 7:43 pm

    I had hormone therapy ( 6 months Lupron injections) and radiation therapy for prostate cancer. My last 3 month injection of Lupron was January 2016. I finished radiation in March. Symptoms of low testosterone have lessened a bit, but by no means are gone. I still cannot build muscle or get rid of the fat that has accumulated around my waist; testicles are not back to normal size, but larger than when I was on the Lupron. My question is, should I expect Testosterone levels to return to normal levels, and if so, how long does that take on average, after treatments are completed? Thank you.

    • Augie Galindo on 10/20/2016 at 3:27 pm

      Bob,

      While prostate cancer treatment and GnRH suppression are not part of what I do, I believe it would be unlikely that testosterone levels would return to normal, or that your urologist/oncologist would even want them to increase while you are still in the short term surveillance period.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  10. Laurie J Overton on 10/14/2016 at 10:21 pm

    Hello…my husband was 56 when diagnosed with Pca in 2009 with stage 3 gleason 8. He went through 2 years hormone therapy…and 43 rounds radiation. He’s having extreme fatigue, losing weight, loss of normal appetite. His psa is 0.21 He was given the 5 good year mark. His t count is 131ng. The VA docs seem to waffle with the conversation…please give us your honest take on this…certainly his cancer is spreading right?

    • Augie Galindo on 10/20/2016 at 3:35 pm

      Laurie,

      Unfortunately, I don’t have enough information here to even hazard a guess. Keep in mind, the prostate specific antigen test is “specific” to the prostate, NOT necessarily specific to cancer. This is a question best left up to his urology/oncology team after perhaps repeating scans.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  11. Dana on 02/25/2017 at 11:33 am

    I am 60 years old I have metastatic prostate cancer to my T8 vertebrae bone and my testerone level is that 15 I’ve been diagnosed t4m one and one my glisten my Gleason is 7 4 + 3 I am getting tired and weak because of my low testosterone and want to raise my testosterone but fear it may feel the cancer although new studies show that by raising the testosterone be different what do you suggest I also get now

    • Augie Galindo on 02/25/2017 at 11:44 am

      Dana,

      I am very sorry for your struggles. Unfortunately, I would not be able to recommend TRT therapy for you. While there is new data that suggests a correlation between the diminution of some prostate cancers in relation to medicinally increased testosterone levels, these studies are not definitive. Also, you would need providers that are at the forefront of both oncology and endocrinology to determine if that would be a remotely safe option for you. I could certainly be wrong, but I just don’t think we are there yet.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  12. […] of the tests we conduct is called a PSA (Prostate Specific Antigen) Velocity test. Its purpose is to track changes over […]

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