Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study finds no causal link between testosterone replacement, prostate cancer or cardiac disease

29.01.2004


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.

Marty Querzoli | EurekAlert!
Further information:
http://www.bidmc.harvard.edu/

More articles from Health and Medicine:

nachricht New discoveries predict ability to forecast dementia from single molecule
12.12.2018 | UT Southwestern Medical Center

nachricht Pain: Perception and motor impulses arise in the brain independently of one another
12.12.2018 | Technische Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

Im Focus: Topological material switched off and on for the first time

Key advance for future topological transistors

Over the last decade, there has been much excitement about the discovery, recognised by the Nobel Prize in Physics only two years ago, that there are two types...

Im Focus: Researchers develop method to transfer entire 2D circuits to any smooth surface

What if a sensor sensing a thing could be part of the thing itself? Rice University engineers believe they have a two-dimensional solution to do just that.

Rice engineers led by materials scientists Pulickel Ajayan and Jun Lou have developed a method to make atom-flat sensors that seamlessly integrate with devices...

Im Focus: Three components on one chip

Scientists at the University of Stuttgart and the Karlsruhe Institute of Technology (KIT) succeed in important further development on the way to quantum Computers.

Quantum computers one day should be able to solve certain computing problems much faster than a classical computer. One of the most promising approaches is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

New discoveries predict ability to forecast dementia from single molecule

12.12.2018 | Health and Medicine

CCNY-Yale researchers make shape shifting cell breakthrough

12.12.2018 | Physics and Astronomy

Pain: Perception and motor impulses arise in the brain independently of one another

12.12.2018 | Health and Medicine

VideoLinks
Science & Research
Overview of more VideoLinks >>>