madman
Super Moderator
Helen L. Bernie, DO, MPH, Director, Sexual and Reproductive Medicine and Assistant Professor of Urology, Indiana University, Carmel, Indiana, presents a review of testosterone therapy in men with prostate cancer, focusing on current evidence and clinical management.
She examines the historical belief that testosterone promotes prostate cancer progression and traces this concept to early studies with limited data. Contemporary evidence is reviewed, including observational studies, retrospective analyses, and randomized trial data evaluating the safety of testosterone therapy.
Dr. Bernie discusses data in men after radical prostatectomy and in those on active surveillance, noting that available evidence does not show increased rates of biochemical recurrence, disease progression, or mortality associated with testosterone therapy. Findings from a large randomized trial in hypogonadal men demonstrate no significant increase in prostate cancer incidence or adverse prostate-related outcomes compared with placebo.
Dr. Bernie outlines a clinical approach to testosterone therapy, including baseline evaluation, assessment of risk factors, and laboratory testing. Emphasis is placed on patient counseling regarding risks and benefits and the importance of shared decision-making.
Monitoring strategies include serial laboratory testing and prostate-specific antigen assessment to evaluate treatment response and detect potential changes over time.
