03/06/2026
TESTOSTERONE THERAPY FOR PROSTATE CANCER PATIENTS?
For years, many people were taught that a history of prostate cancer automatically meant a man could never receive testosterone therapy.
Medicine has evolved since then.
Back in the 1940s, research by Huggins and Hodges showed that lowering testosterone could shrink metastatic prostate cancer. That work was important and earned a Nobel Prize. But it also led to a widespread belief that any testosterone exposure would automatically stimulate prostate cancer growth.
More recent research and clinical experience have shown that the relationship is more nuanced.
Today, major medical organizations acknowledge that testosterone therapy can be considered in certain men with a history of prostate cancer, particularly those who have been definitively treated and have no evidence of active disease. The key is careful patient selection and close monitoring.
The American Urological Association (AUA) guidelines state that testosterone therapy may be offered to hypogonadal men with a history of prostate cancer on a case-by-case basis, with clear counseling about the current evidence and the need for careful follow-up. These guidelines recommend:
• Targeting testosterone levels in the mid-normal range (about 600 ng/dL)
• Close monitoring with labs and PSA testing every 3–6 months
• Early and frequent PSA checks when therapy is initiated
• Using shorter-acting testosterone options initially so therapy can be adjusted quickly if needed
• Full informed consent and coordination with the patient’s urologist or oncologist
As part of my advanced training through the Sexual Medicine Society of North America, I received education specifically on the use of testosterone therapy in men with prostate cancer. This is a complex area of medicine that requires thoughtful decision-making, transparency with patients, and collaboration with specialists.
The most important point is this:
Testosterone therapy is not automatically excluded for every man with a history of prostate cancer.
In carefully selected patients, with appropriate monitoring and collaboration with their cancer specialists, it may still be an option to improve quality of life and address true testosterone deficiency.
As always, decisions about testosterone therapy should be individualized, evidence-based, and made together with your healthcare team.
References
Hilton, L. (2023). How testosterone therapy use in men with prostate cancer has evolved. Urology Times.
Ramasamy, R., Fisher, E., & Schlegel, P. (2012). Testosterone replacement and prostate cancer. Indian Journal of Urology, 28(2), 123. https://doi.org/10.4103/0970-1591.98449
Ziegelmann, M. J., & Collins, C. S. (2023). Testosterone Replacement After Definitive Prostate Cancer Treatment: Where Do We Stand? AUA News.
