Effects of testosterone therapy on prostate cancer

The field of clinical prostate cancer research is an exercise in balance. Functional outcomes—such as erectile dysfunction and urinary incontinence—are weighed against oncologic outcomes. In deciding whether to recommend active surveillance versus active treatment, we balance the patient’s age, comorbidity, the severity of their cancer, and their personal preferences. Likewise, in considering whether to give testosterone therapy to men with both hypogonadism and prostate cancer, we navigate the tightrope with extreme caution. As men age, the prevalence of both hypogonadism and prostate cancer both increase and seeing men in the clinic with both conditions is not uncommon. Due to the long-believed notion that testosterone therapy would cause treated prostate cancer to recur and untreated disease to flare, many hypogonadal men have gone untreated throughout the years.