The AUA released its guidelines in 2018, making a strong recommendation that clinicians should inform patients of the absence of evidence linking testosterone therapy to the development of prostate cancer, according to Mohit Khera, MD, professor of urology at Baylor College of Medicine, in Houston, Texas. Patients treated for localized CaP with no evidence of active disease (measurable PSA, abnormal digital rectal examination findings, evidence of bone or visceral metastases) are candidates for replacement under the Canadian Medical Association Journal, European Association of Urology (EUA), and British Society for Sexual Medicine guidelines (BSSM).” 1 Only the AUA and ISSM recommend offering T on a case-by-case basis for all patients with CaP. The Endocrine Society has the strictest guidelines, advising against T in patients with an unevaluated prostate nodule, PSA >4ng/mL, or PSA >3ng/mL in high-risk patients (i.e., African Americans or first-degree relative with CaP). The authors of an editorial comment published earlier this year in the International Brazilian Journal of Urology found: “Last guidelines’ revisions show some changes on CaP as a definitive contraindication for TRT. Guideline recommendations, however, don’t fully reflect reality. But these men should be closely monitored, they stress. Burnett II, MD, professor of urology at Johns Hopkins University, in Baltimore, Maryland, and author of the new book The Manhood Rx: Every Man’s Guide to Improving Sexual Health and Overall Wellness.īased on current studies and anecdotal evidence, many of today’s urologists think it’s relatively safe to administer testosterone replacement in hypogonadal men on active surveillance or in those who have been treated with prostatectomy or cryosurgery. Charles Brenton Huggins, who received the Nobel Prize for his work, demonstrated that if you shut down a man’s hormones you can control advanced prostate cancer, explained to Arthur L.

Until the past decade or so, he added, urologists were afraid of giving testosterone to men with any kind of prostate cancer for fear of “fueling the fire.”Īuthors Huggins and Hodgkins laid the foundation for those fears in the 1940s, when they discovered that androgenetic hormones and prostate cancer were linked. Now, probably 75% to 80% of urologists will give testosterone to men in these circumstances,” he observed. “About 20 years ago, when I gave a course at the American Urological Association and would ask if anybody in the audience would give testosterone to a man who had prostate cancer, 3 of maybe 300 to 400 urologists would put up their hands. MD, professor of urology and chief of andrology at Tulane University School of Medicine, in New Orleans, Louisiana.

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