Does testosterone increase my prostate cancer risk?

A persistent concern that is still hanging over the heads of many men is whether testosterone can cause prostate cancer. Here’s a news bulletin: it’s not T you should be worrying about—it’s estrogen.

Why do I say that? Here’s the story, and it has to do with a paradox: As men age, their T levels decline, yet their chances of developing prostate cancer goes up. This suggests that low T (not high) could be a factor in prostate cancer and that something else—another hormone that often rises in aging men—could be involved as well. That other hormone is estrogen.

Let’s look at T and prostate cancer first…

At the American Urological Association Annual Meeting in May 2015, experts presented the results of a meta-analysis indicating that both natural and prescription testosterone do not cause prostate cancer nor increases in the level of prostate-specific antigen (PSA). ¹ Although this comprehensive review (which involved 42 studies) is not the final nail in the coffin of T and prostate cancer, it certainly significantly tightens the lid.

As for T’s protective effect against prostate cancer, the jury is still out. However, several reports explain how men who received testosterone therapy after treatment for localized prostate cancer had little or no recurrence of disease. In addition, some men with untreated prostate cancer who took T therapy have not experienced disease progression. ²

Yet another study found that 98 men with excessively low T who were treated with testosterone therapy after radiation for prostate cancer saw a rise in mean T levels (from 209 ng/Dl to 420 ng/dL) after treatment without a significant rise in PSA levels. ³

Now let’s talk about estrogen and prostate cancer. We have evidence, at least in rats, that T plus E are necessary for prostate cancer to develop. In men, however, the research is still mixed when it comes to the association between estrogen and an increased risk of prostate cancer, however it’s enough to be a serious warning.

Experts agree that a man’s T:E ratio should reflect higher testosterone than estrogen. Because T can be transformed into estrogen with the help of an enzyme called aromatase, you need to take steps to reduce the activity of this enzyme.

That means maintaining a healthy weight, dropping excess body fat (since fat promotes production of estrogen), avoiding or limiting alcohol use, keeping blood sugar levels in a healthy range, and maybe taking some natural, scientifically proven nutrients and supplements that can help support your normal T levels.

The bottom line is that testosterone doesn’t appear to cause prostate cancer nor have a detrimental effect on men who already have the disease. In fact, it seems that too much estrogen is the real culprit.

[1] American Urological Association (AUA) 2015 Annual Meeting: Abstract MP4-09. Presented May 15, 2015.
[2] Khera M et al. A new era of testosterone and prostate cancer: from physiology to clinical implications. European Urology 2014 Jan; 65(1): 115-23.
[3] Pastuszak AW et al. Testosterone therapy after radiation therapy for low, intermediate and high risk prostate cancer. Journal of Urology 2015 Nov; 194(5): 1271-76.