Testosterone Therapy and Prostate Cancer.
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanistic models and clinical literature without systematic review methodology.
PubMed 27132578 · doi:10.1016/j.ucl.2016.01.007
What was done
The author reviewed evidence concerning the relationship between testosterone and prostate cancer growth, focusing on the biological saturation model and the practice of administering testosterone replacement therapy to men with a prior history of prostate cancer.
What was found
The abstract reports that androgen stimulation of prostate cancer growth is finite, reaching a maximal stimulation plateau (saturation point) at a testosterone concentration of 250 ng/dL. Clinical outcomes from treating men with a history of prostate cancer are described as reassuring, though no specific numerical outcomes, risk ratios, or patient sample sizes are reported.
Why it matters
This review outlines the conceptual shift away from the belief that higher testosterone monotonically increases prostate cancer growth, supporting the clinical exploration of testosterone therapy in hypogonadal men treated for prostate cancer.
Limits
The abstract describes a narrative review rather than a systematic review or meta-analysis. It explicitly notes that no prospective controlled trials exist to validate the safety or oncologic outcomes of testosterone therapy in men with a history of prostate cancer. No quantitative data or study counts are provided in the abstract.
Cited by
- supports According to the androgen saturation model, increasing testosterone from hypogonadal to eugonadal levels (around 300+ ng/dL) stimulates prostate growth and increases PSA, but prostate androgen receptors saturate and further increases in testosterone do not dose-dependently increase prostate size.