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The safety of testosterone supplementation therapy in prostate cancer

Nature Reviews Urology volume 11, pages 526–530 (2014)Cite this article

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Abstract

Patients with prostate cancer can present with hypogonadism and experience health and quality-of-life declines related to low testosterone levels. Despite generations of urological dogma suggesting that testosterone supplementation therapy (TST) for hypogonadism causes prostate-cancer progression, a review of the contemporary literature provides evidence to the contrary. The prostate saturation model suggests that the androgen receptor (AR) is saturated at serum testosterone levels of 150–200 ng/dl, and that additional serum testosterone above this level has limited, if any, effects within the prostate. Indeed, studies in the modern era of PSA assessments indicate that TST does not affect prostate size, intraprostatic testosterone levels, or prostate-cancer progression, provided the baseline serum testosterone level is greater than this AR saturation point. However, the body of data on this subject comes from a small number of cases, and TST should only be administered to patients with prostate cancer after thorough discussions of the risks and benefits, with subsequent careful monitoring.

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Authors and Affiliations

  1. Scott Department of Urology, Baylor College of Medicine, 6624 Fannin Street, Houston, 77030, TX, USA

    James M. Dupree, Gavin M. Langille, Mohit Khera & Larry I. Lipshultz

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  2. Gavin M. Langille
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  4. Larry I. Lipshultz
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Contributions

All authors researched the data for the article, made substantial contributions to discussion of content and reviewed/edited the manuscript before submission. J.M.D., G.M.L., and L.I.L. contributed to writing the article.

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Correspondence to Larry I. Lipshultz.

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Competing interests

M.K. declares that he has acted as a consultant for Auxillium, Merck, Meda, and Lilly. L.I.L. declares that he is a member of the speakers' bureau and/or has received honouraria from, and has acted as a consultant for, Auxillium, Endo, Respro Therapeutics, and Lilly. J.M.D. and G.M.L declare no competing interests.

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Dupree, J., Langille, G., Khera, M. et al. The safety of testosterone supplementation therapy in prostate cancer. Nat Rev Urol 11, 526–530 (2014). https://doi.org/10.1038/nrurol.2014.163

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