Effect of testosterone replacement therapy on incidence of prostate cancer

[Roger__0__0]

  I'm age 60 and, due to low testosterone level with no other abnormalities, my doctor recommended 5mg Testoderm patches.  He cited increased risk of prostate cancer but could not quantify the increase.  I had a vasectomy about 25 years ago.  What does the literature suggest the incidence of prostatic cancer is for me a) with and b) without taking the Testoderm.
  (I'm familiar with the fact that low-testosterone levels may diminish the effectiveness of DRE and PSA tests.)  A source of relevant information would be appreciated.
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Dear Roger,
I looked at the PDR which lists any contraindications and any relevant tests that might correspond to your question.  The company that produces Testoderm lists that patients with documented prostate cancer should not receive Testoderm.  They recommend that the usual screening for prostate cancer, DRE and PSA, should continue as normally scheduled.
Yes, testosterone replacement can theoretically increase the ability of the prostate cells to grow (this is the normal physiologic property of testosterone). It does not alter the cells of the prostate and make them become cancerous.  We do not over replace the amount of testosterone in the body with this medication, you simply prescribe enough to bring a patient’s hormonal balance into the normal range.  Therefore, a patient who does not have prostate cancer should not develop cancer from this medication.
There may be significant variation in testosterone levels in the course of the day. I would suggest that you have two morning samples drawn to confirm the levels (total testosterone). Be aware that you should  be checked for breast lumps initially and on follow-up visits. The major benefit for you, given that you do not have hot flashes or sexual dysfunction relates to the avoidance of osteoporosis.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Testosterone