Effects Of Testosterone (T) Administration On Prostate Tissues

UroToday.com - Dr. Leonard Marks, Culver City, California reported a multicenter randomized clinical trial of the effects of testosterone (T) administration on prostate tissues in 48 patients with androgen decline of aging male (ADAM).

After baseline 14 core transrectal ultrasound guided prostate biopsy excluded 4 men with cancer, the remainder received intramuscular depo T or placebo for 6 months and then underwent repeat biopsy. At baseline serum total T average 299 ng/dl; PSA 1.3 ng/ml; prostate volume 46.9 cc. At 6 months follow-up there was no change in prostate levels of T and DHT, prostate tissue biomarkers, PSA, prostate volume or lower urinary tract symptoms despite increase in serum T levels in treated men to 693 ng/dl. An additional 6 men (4 on placebo) were found to have prostate cancer.

Therefore, overall 10 of 48 men (20.8%) were found to have prostate cancer in this trial, but no prostate tissue changes were found following T administration.

Editor's note: Testosterone replacement therapies for truly hypogonadal men and testosterone supplementation for men with low but normal levels of testosterone, has always raised the fear of aggravation of prostate symptoms and/or stimulation of prostate cancer. This study although small looked at clinical, biochemical and intracellular markers of change in the prostate of men receiving intramuscular testosterone versus placebo. The high rate of detection of prostate cancer (20%) found among subjects does nothing to alleviate concern about cancer risks in this patient population.

AUA 2006 - Abstract #691

Reviewed by UroToday.com Contributing Editor Joel Kaufman, MD

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