With proper clinical monitoring, testosterone therapy is safe for the prostate and improves early detection of prostate cancer (PCa), according to a new British study.

Mark R. Feneley, MD, of University College Hospital London, and Malcolm Carruthers, MD, of the Center for Men’s Health in London, studied 1,365 men aged 28-87 years with symptomatic androgen deficiency and receiving testosterone replacement therapy (TRT). Over a 20-year period, 14 new PCa cases were diagnosed after 2,966 man-years of treatment (one case per 212 years), the researchers reported online in the Journal of Sexual Medicine. The incidence of PCa was equivalent to that expected in the general population, Drs. Feneley and Carruthers stated. All tumors were clinically localized and suitable for potential curative treatment, they reported. Initiating TRT had no statistically significant effect on total PSA, free PSA, or free/total PSA ratio. Any initial PSA change did not predict subsequent PCa diagnosis.

“Testosterone treatment with regular monitoring of the prostate may be safer for the individual than any alternative without surveillance,” the authors wrote.

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They observed that the main concern limiting the introduction of testosterone treatment in men relates to the progression of undiagnosed PCa or its development with advancing age. The findings of their study and those of previous investigations “all point to any putative link between TRT and the induction of PCa being indeed a myth.”

“Physicians and surgeons considering the many potential benefits of TRT for their patients should not be deterred from giving it by theoretical fears, where careful and regular safety monitoring is in place,” the authors concluded.