Featured Research

from universities, journals, and other organizations

Study Finds No Causal Link Between Testosterone Replacement, Prostate Cancer Or Cardiac Disease

Date:
January 30, 2004
Source:
Beth Israel Deaconess Medical Center
Summary:
A retrospective analysis by researchers at Beth Israel Deaconess Medical Center published in The New England Journal of Medicine found no causal relationship between testosterone replacement and prostate cancer or heart disease risk.

BOSTON -- A retrospective analysis by researchers at Beth Israel Deaconess Medical Center published in The New England Journal of Medicine found no causal relationship between testosterone replacement and prostate cancer or heart disease risk.

The comprehensive review of 72 studies, addresses the current controversy about testosterone replacement therapy and its potential health risks to men.

"We reviewed decades of research and found no compelling evidence that testosterone replacement therapy increases the incidence of prostate cancer or cardiovascular disease," said Abraham Morgentaler, MD, a urologist at BIDMC and associate clinical professor at Harvard Medical School. "Although it would be helpful to have data from long-term, large-scale studies, it must also be recognized that there already exists a substantial body of research on the effects of testosterone in men."

Low levels of testosterone affect an estimated 2 to 4 million men in the United States, a condition termed hypogonadism, and the prevalence of this condition increases with age. The symptoms include diminished libido and sense of vitality, erectile dysfunction, reduced muscle mass and bone density, depression, and anemia.

The causes of hypogonadism may be classified as primary, meaning inadequate function of the testes; secondary, inadequate pituitary stimulation of the testes; or a combination of primary and secondary causes, which is common in older men. Testosterone supplementation, in the form of injections, patches, gels and a buccal tablet, is designed to elevate a hypogonadal man's testosterone levels into the normal physiologic range and alleviate symptoms.

"Testosterone is only for men who have symptoms of low testosterone combined with a confirmatory blood test. Testosterone therapy can be beneficial and safe for these men as long as they are appropriately monitored by their physician," says Morgentaler.

It has been known since the 1940's that severe reductions of testosterone can cause shrinkage of metastatic prostate cancer, and therefore there has been a concern that raising testosterone levels might cause growth of any hidden prostate cancers. However, the study by Ernani L. Rhoden, M.D., and Morgentaler found no connection between higher testosterone levels and prostate cancer, nor did they find evidence that testosterone treatment causes prostate cancer.

In fact, they note that prostate cancer becomes more prevalent exactly at the time of a man's life when testosterone levels decline. To date, prospective studies have demonstrated no difference in prostate cancer incidence among hypogonadal men using testosterone therapy compared to men in the general population.

Regarding benign prostatic hyperplasia (BPH), multiple studies have failed to demonstrate consistent exacerbation of voiding symptoms during testosterone supplementation. "The impact of testosterone therapy on benign prostate growth appears to be mild," says Rhoden, "and rarely of clinical significance. However, testosterone therapy should be used cautiously in men with severe urinary symptoms."

Monitoring the prostate during testosterone therapy is mandatory, given the theoretical concern that testosterone treatment may stimulate the growth of an occult cancer. Before and during treatment men should undergo regular evaluation, with a digital examination of the prostate, and a blood test called prostate-specific antigen (PSA). Patients with an abnormal prostate exam or an elevated PSA should undergo a prostate biopsy before initiating testosterone replacement to exclude the possibility that cancer is present. To monitor BPH, they recommend determining a base-line voiding history at the start of treatment and assessing urinary symptoms at follow-up.

The belief that testosterone may be a risk factor in cardiovascular disease is based on the observation that more men than women have cardiovascular events and men have higher testosterone levels than women. However, Rhoden and Morgentaler write that few, if any, data support a causal relation between higher testosterone levels and heart disease.

Indeed, several studies suggest that higher testosterone levels may actually have a favorable effect on atherosclerosis and heart disease. Studies of testosterone replacement therapy have not demonstrated an increased incidence of cardiovascular disease, myocardial infarction, stroke, or angina, according to the retrospective analysis.

Rhoden and Morgentaler describe other potential risks or side effects from testosterone replacement therapy as infrequent (acne or oily skin, sleep apnea); rarely of clinical significance (fluid retention); or reversible with cessation of treatment (gynecomastia, testicular atrophy or infertility). Testosterone treatment should be used cautiously or not at all in men with advanced liver disease. Skin reactions are commonly encountered in men being treated with the patch with a low incidence observed with testosterone gel.

###

Beth Israel Deaconess Medical Center is a major patient care, teaching and research affiliate of Harvard Medical School, and ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a founding member of the Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox.


Story Source:

The above story is based on materials provided by Beth Israel Deaconess Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Beth Israel Deaconess Medical Center. "Study Finds No Causal Link Between Testosterone Replacement, Prostate Cancer Or Cardiac Disease." ScienceDaily. ScienceDaily, 30 January 2004. <www.sciencedaily.com/releases/2004/01/040129072631.htm>.
Beth Israel Deaconess Medical Center. (2004, January 30). Study Finds No Causal Link Between Testosterone Replacement, Prostate Cancer Or Cardiac Disease. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2004/01/040129072631.htm
Beth Israel Deaconess Medical Center. "Study Finds No Causal Link Between Testosterone Replacement, Prostate Cancer Or Cardiac Disease." ScienceDaily. www.sciencedaily.com/releases/2004/01/040129072631.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins