Challenging beliefs of testosterone therapy and prostate cancer

Article metrics

The relationship between testosterone therapy and prostate cancer continues to challenge historic and current beliefs. A new cohort analysis revealed a ~33% reduction in prostate cancer incidence in men with increased testosterone use. The mechanisms underlying this protective effect are unclear, but these findings challenge current paradigms and warrant further investigation.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Testosterone deficiency, metabolic syndrome and prostate cancer.


  1. 1.

    Stavropouls, K. et al. Testosterone replacement therapy and cardiovascular risk - a closer look at additional parameters. JAMA Intern Med. 117, 1393 (2017).

  2. 2.

    Lopez, D. S. et al. Association of the extent of therapy with prostate cancer in those receiving testosterone therapy in a US commercial insurance claims database. Clin. Endocrinol. (2019).

  3. 3.

    Loeb, S. et al. Testosterone replacement therapy and risk of favorable and aggressive prostate cancer. J. Clin. Oncol. 35, 1430–1436 (2017).

  4. 4.

    Isbarn, H. et al. Testosterone and prostate cancer: revisiting old paradigms. Eur. Urol. 56, 48–56 (2009).

  5. 5.

    Fizazi, K. et al. Darolutamide in nonmetastatic, castration-resistant prostate vancer. N. Engl. J. Med. 380, 1235–1246 (2019).

  6. 6.

    Endogenous Hormones and Prostate Cancer Collaborative Group. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J. Natl Cancer Inst. 100, 170–183 (2008).

  7. 7.

    Pastuszak, A. W. et al. Testosterone therapy and prostate cancer. Transl Androl. Urol. 5, 909–920 (2016).

  8. 8.

    Ahlering, T. E. et al. Is there a role for testosterone replacement in reducing biochemical recurrence following radical prostatectomy? J. Clin. Oncol. 37, 5085–5085 (2019).

  9. 9.

    Kasper, J. S., Liu, Y. & Giovannucci, E. Diabetes mellitus and risk of prostate cancer in the health professionals follow-up study. Int. J. Cancer 124, 1398–1403 (2009).

  10. 10.

    Lee, J. et al. Diabetes and mortality in patients with prostate cancer: a meta-analysis. Springerplus 5, 1548 (2016).

Download references

Author information

Correspondence to Thomas E. Ahlering.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Huynh, L.M., Ahlering, T.E. Challenging beliefs of testosterone therapy and prostate cancer. Nat Rev Urol (2019) doi:10.1038/s41585-019-0253-8

Download citation