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TRT key points
The Heart and TRT
The Prostate and TRT
Safety of TRT
Availability of
TRT
Viagra and TRT
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There is no convincing evidence
to show that TRT causes either benign enlargement or cancer of the prostate |
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Careful screening of TRT
patients shows up any early signs of prostate problems, (which are very
treatable in early stages), so TRT patients have the added benefit of
knowing they do not have prostate cancer. |
Is Testosterone Treatment safe for the prostate?
Dr Thomas Stuttaford has in the last few years written in
his medical column in the Times about his operation for prostate cancer. Though not as far
as I know on any testosterone treatment, he was certainly an enthusiastic supporter of it,
and has written several excellent articles about it. Being an expert in men's health, he
is also keen on all men over the age of fifty having the key early-warning screening test
of the Prostate Specific Antigen (PSA) test done regularly, as the outlook is so much
better if the cancer is diagnosed early.
| However, as with so many doctors, he left
himself out of the screening programme he recommended to others, until his oldest friend,
who had recently found he had advanced prostate cancer which had spread, insisted he had
it done himself. Fortunately, in his case the PSA was 8.8, only just over double the
age-related upper limit of normal, usually taken as four, and the cancer was confined
within the capsule of the prostate gland. This made complete excision possible in the
hands of an expert urological surgeon, and there is a 90% chance that cure will be
complete with no long-term complications. |
This cautionary tale emphasises the need before starting testosterone treatment for an
expert physical check, with special emphasis on the heart and arteries, testicles, penis
and of course examination of the prostate gland. For those over fifty, it is advisable to
have a Transrectal Ultrasound examination of the prostate, in addition to the mandatory
Prostate Specific Antigen (PSA) blood test which has probably saved Dr Stuttaford's life.
Newer advances in PSA testing, measuring total and free forms of PSA may make the
ultrasound examination, which is quite expensive and seldom popular, necessary less often,
and is one of the latest advances in testing being used in the e-medicine AndroScreen
Clinic.
Though the case for early detection of prostate cancer is still being fiercely debated by
the for and against early treatment lobbies, twelve cases of early non-invasive prostate
cancer were found prior to testosterone treatment in my first thousand patients. Only four
have developed it during treatment, and these were picked up by the six-monthly repeat
screens at an early, treatable stage. This would suggest that, by providing the benefit of
this careful repeated screening, testosterone treatment is overall more likely to save
lives from prostate cancer than to cause it.
Testosterone treatment has been used in a multitude of studies right round the world,
often in much higher doses then those used to treat the andropause without any convincing
evidence of it causing either benign enlargement or cancer as established from a
literature search.
Studies carried out in Amsterdam with one oral preparation, Andriol, have not shown any
adverse effects in serial tests in patients treated for over 20 years. The WHO multicentre
trials of testosterone in high doses given to young fit men for a year or two have not
shown any problems. A Danish doctor, Jens Moller with whom I worked, gave very high doses
of testosterone to over 3,000 men with circulatory disease over a thirty year period,
without prostate problems developing. Lastly, my own carefully monitored series of over
1,000 patients studied for periods up to 10 years has not shown any problems either.
I tell my patients under testosterone treatment that at least they know they do not have
prostate cancer, but there are many men, including doctors, who have the condition, but
don't know it. back to top
Testosterone ... key to
mens' health |