What is the Origin of Prostate Cancer Safety?

The clinical concern originated from the "androgen hypothesis" proposed in the 1940s, which posited that testosterone fuels prostate cancer growth, leading to a historical contraindication for TRT in men with any prostate cancer history. Modern, large-scale, randomized controlled trials, such as the TRAVERSE trial, have largely refuted this association in carefully screened hypogonadal men, but the principle of safety and diligent monitoring remains a cornerstone of clinical practice.

What is the Mechanism of Prostate Cancer Safety?

The safety mechanism relies on regular monitoring of serum Prostate-Specific Antigen (PSA) levels and performing a Digital Rectal Examination (DRE) at specified intervals, typically more frequently in the first year of therapy. Testosterone administration typically causes a modest increase in PSA during the first year as the prostate returns to a eugonadal state, but a confirmed, sustained elevation above established thresholds necessitates immediate urological referral for further evaluation, including potential biopsy, to rule out high-grade cancer.

Prostate Cancer Safety

Meaning

Prostate Cancer Safety refers to the clinical strategy and ongoing monitoring required to minimize the theoretical risk of stimulating prostate cancer growth or progression in men receiving Testosterone Replacement Therapy (TRT) for hypogonadism. This protocol centers on rigorous baseline screening and consistent surveillance of prostate health parameters to ensure the benefits of TRT outweigh any potential, though currently unsupported by large trials, prostate-related risks. Patient selection and informed consent are paramount to this process.