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15 October 2016

Dispelling the myth of testosterone treatment and prostate cancer

Dispelling the myth of testosterone treatment and prostate cancer

Testosterone treatment is not associated with increased risk of prostate cancer or worsening of lower urinary tract symptoms: prostate health outcomes in the Registry of Hypogonadism in Men. Debruyne FM, Behre HM, Roehrborn CG, et al. BJU Int. 2017;119(2):216-224.

Fear of prostate cancer remains one of the major concerns with testosterone therapy among doctors, and reason to deny suffering hypogonadal men testosterone treatment. This fear persists despite mounting research over the past decade that has clearly refuted the belief that testosterone therapy increased risk of prostate cancer among men in the general population. Aside prostate cancer, benign prostatic hyperplasia (BPH) with its associated lower urinary tract symptoms (LUTS) are also common concerns with testosterone therapy.

In this editorial we summarize and comment on the results of the Registry of Hypogonadism in Men (RHYME) study; a large, multi-national prospective registry of men with testosterone deficiency, which was designed and powered specifically to assess prostate cancer outcomes in hypogonadal men receiving testosterone therapy compared with untreated hypogonadal men or general population estimates.

Key Points

  • BPH, LUTS and prostate cancer have long been considered major risks associated with testosterone therapy, but accumulating research shows these fears are unfounded.
  • The RHYME study showed that testosterone therapy does not increase prostate cancer incidence or BPH/LUTS progression compared to matched untreated men.
  • There were no differences in PSA levels, total IPSS, or the IPSS obstructive sub-scale score in testosterone treated men compared to untreated men.
  • Testosterone therapy may improve voiding symptoms.
  • Testosterone therapy has no clinically significant adverse impact on prostate cancer incidence among men regardless of administration method.

Last updated: 2019