Serum Testosterone Level, Testosterone Replacement Treatment, and Prostate Cancer

Ali Atan, Altug Tuncel, Suleyman Yesil, and Derya Balbay

Advances in Urology Volume 2013, Article ID 275945, 7 pages

This article reviews the following questions in regards of Testosterone Replacement Therapy (TRT) and Prostate Cancer (PCa).

1. How Does Prostate Tissue Interact with Serum Testosterone (T)?

With increased levels of Testosterone, there is no direct correlation between serum T levels and intraprostatic hormonal T levels.

2. Is There Any Relationship between Serum T Level and PCa?

There is an inverse correlation between age and PCa is developed and serum T level. Diagnosis of PCa is lowest during 20’s and 30’s when serum T levels are the highest. While Diagnosis of PCa is the highest after age 60 when serum T have vastly decreased.

This data indicates that serum T levels do not have a significant role in the development of PCa.

3. Does TRT Have Any Role in the Development of PCa?

The authors concluded that TRT in men with testosterone deficiency IS safe when carefully and regularly monitored. Also TRT neither increases the risk of PCa diagnosis in normal men nor causes cancer recurrence in men who were successfully treated for PCa.

4. Can Patients Who Are at High Risk of Developing PCa Be Placed on TRT?

Still be investigated, but current studies suggest certain types of PCa can be treated with TRT but should be monitor closely.

5. Can Patients with the Diagnosis of PCa Receive TRT?

• TRT in Patients with Untreated PCa

          Active investigation continues.  Recent reports are encouraging of TRT in PCa, with improvements of elevated PSAs and decrease in low t symptoms.

• TRT in Patients Who Received Treatment for PCa

          Patients who have received external radiation recent studies have been encouraging with improvement of low t symptoms. Should be followed closely with PSA’s and DRE’s.

6. TRT in Patients Who Received Treatment for PCa Previously?

The European Association of Urology Guidelines recommends to begin TRT in first year after the surgical removal of the prostate. Radiotherapy of PCa:  current recommendations require a PSA level <1 ng/mL due to tissue remaining in the body.

7. TRT and Serum PSA Level

TRT causes minor increase in PSA. There is NO correlation between serum T levels and serum PSA levels. PSA’s should be checked every 6 months to 1 year on therapy at the discretion of your provider.