Men's Health Boston Harvard Medical School, One Brookline Place, Suite
#624, Brookline, MA 02445, USA.

amorgent@bidmc.harvard.edu

Since the early 1940s when Huggins showed that severe reductions in
serum testosterone by castration or estrogen therapy caused regression
of prostate cancer (PCa), it has been assumed that higher testosterone
levels cause enhanced growth of PCa. For this reason, it has been
considered taboo to offer testosterone replacement therapy (TRT) to any
man with a prior history of PCa, even if all objective evidence suggests
he has been cured. The fear has been that higher testosterone levels
would "awaken" dormant cells and cause a recurrence.

Thus, US Food and Drug Administration-mandated language in all
testosterone package inserts states that testosterone is contraindicated
in men with a history of, or suspected of having, PCa. Although there is
little modern experience with administration of testosterone in men with
known history of PCa, there is a varied and extensive literature
indicating that TRT does not pose any increased risk of PCa growth in
men with or without prior treatment. For instance, the cancer rate in
TRT trials is only approximately 1%, similar to detection rates in
screening programs, yet biopsy-detectable PCa is found in one of seven
hypogonadal men. Moreover, PCa is almost never seen in the peak
testosterone years of the early 20s, despite autopsy evidence that men
in this age group already harbor microfoci of PCa in substantial
numbers. The growing number of PCa survivors who happen to be
hypogonadal and request treatment has spurred a change in attitude
toward this topic, with increasing numbers of physicians now offering
TRT to men who appear cured of their disease.

Publications have now reported no prostate-specific antigen (PSA)
recurrence with TRT in small numbers of men who had undetectable PSA
values after radical prostatectomy. Although still controversial, there
appears to be little reason to withhold TRT from men with favorable
outcomes after definitive treatment for PCa. Monitoring with PSA and
digital rectal examination at regular intervals is recommended.

PMID: 16904053 [PubMed - in process]

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc