Myths about Testosterone Treatment – Testosterone and the prostate

By Dr Malcolm Carruthers

“The great enemy of the truth is very often not the lie - deliberate, contrived and dishonest, but the myth, persistent, persuasive, and unrealistic. Belief in myths allows the comfort of opinion without the discomfort of thought.”  John F. Kennedy

For over 60 years, since the idea was dreamt up by a famous American urologist called Charles Huggins, the myth persisted that testosterone treatment is dangerous for the prostate. It was based on one patient of his with prostate cancer who appeared to get worse on testosterone replacement treatment (TRT), and temporarily better when treated with the female hormone oestrogen.

This simplistic idea became enshrined in the anti-testosterone movement, and many prostate cancer victims were physically or chemically castrated to slow the growth of the tumour. This it did for a few months, but at the cost of bringing on the side effects of a testosterone deficient state, with loss of libido, potency and brain fog which often severely reduced his quality of life.

Also the idea seemed to ignore the fact that often it was men with low testosterone levels who developed prostate cancer, and that it only becomes common in men over the age of fifty whose testosterone levels are falling naturally who develop the condition. Also, intrepid patients using TRT for many years because of the general benefits they experienced in losing their low testosterone life and love limiting symptoms, obstinately refused to develop prostate cancer above the rate experienced by the general population. It was a case of a beautiful theory slain by a few ugly facts.  Undeterred the medical establishment, whenever TRT was mentioned, would appear waving shrouds marked 'Whoa beware prostate cancer'.

It was not until a bold young American Professor of urology at Harvard Medical School developed a theory that there was a low threshold of testosterone above which there was no increased risk of cancer.

“Fortunately,” Dr. Morgentaler concludes on his highly recommended web site 'Wellness Profile', and in his excellent new book  'Testosterone for Life', “all of these barriers are now relaxing, as it becomes clear how many body systems rely on healthy, normal T levels, and how normal T levels contribute to prevention of cardiovascular disease, diabetes, and the metabolic syndrome.”

He is even taking his ideas into his clinic, successfully treating some patients who are at high risk of prostate cancer, or even have had the condition and been treated for it, with TRT.

His experience coincides with that of Consultant Urologist Mr Mark Feneley and myself in treating  2,500 patients over 25 years with TRT, at the Centre for Men's Health, with careful monitoring of the prostate. As reported in the leading American Journal of Sexual Medicine in 2012, with an article we dared to call 'Is testosterone treatment good for the prostate?  Study of safety during long-term treatment', showing there was no increase in prostate cancer men having TRT, and no rise in the early warning marker the Prostate Specific Antigen (PSA).

Instead many men showed not only benefits in losing the symptoms of testosterone deficiency, but had improvement in 'lower urinary tract symptoms' such as frequency of passing water more frequently especially at night. This illustrates the point that TRT causes neither benign nor malignant prostate conditions, but is good for the health of the entire urinary tract.

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