Blue November and the Role of Testosterone Replacement Therapy in Men’s Health
Blue November is a global awareness campaign focused on the importance of early diagnosis of prostate cancer. Throughout the month of November, the campaign encourages men to take care of their health and undergo essential preventive examinations.
Blue November is a global awareness campaign focused on the importance of early diagnosis of prostate cancer. Throughout the month of November, the campaign incentivizes men to take care of their health and undergo essential preventive examinations.
Prostate cancer is the second most common type of cancer among men, only behind skin cancer. In Brazil, a man dies from this disease every 38 minutes. Despite this, there is still significant controversy over whether Testosterone Replacement Therapy (TRT) can increase the risk of prostate cancer. However, several studies already suggest that this relationship is unlikely.
Recently, research published in the prestigious JAMA thoroughly examined the effects of TRT concerning prostate cancer and other prostatic events. The study, titled “Prostatic Safety Events During Testosterone Replacement Therapy in Men with Hypogonadism”, was a randomized, double-blind clinical trial with 5,246 participants. It compared the effects of TRT with a placebo in men aged between 45 and 80, all with low testosterone levels (below 300 ng/dL). Men with elevated PSA levels (>3.0 ng/mL) or severe urinary symptoms were excluded.
Main Conclusions from the Testosterone and Prostate Health Study
- Prostate Cancer Risk: There were no significant differences in the incidence of prostate cancer between the TRT and placebo groups, indicating that testosterone hormone therapy does not increase the risk of high-grade cancer.
- Secondary Events and Urinary Symptoms: The incidence of acute urinary retention, procedures for benign prostatic hyperplasia (BPH), and treatments for urinary symptoms also did not differ significantly between the groups. PSA levels increased slightly in the TRT group but stabilized after 12 months, with no significant progression of urinary symptoms.
- Monitoring and Safety: This is one of the largest randomized studies on TRT and prostate cancer to date. The evidence is robust and supports that hormone therapy does not increase the risk of serious prostate-related events in men carefully selected for treatment.
Despite the positive evidence, the study has limitations. Individuals with a history of prostate cancer and elevated PSA levels were excluded, and the 33-month follow-up, while extensive, may not be sufficient to fully assess the long-term effects of TRT. Another factor was the high discontinuation rate in both the TRT and placebo groups, primarily due to the COVID-19 pandemic, which affected participant follow-up.
Final Considerations on Hormonal Therapy and Blue November
This study reinforces the safety of Testosterone Replacement Therapy in men with hypogonadism, providing additional support for physicians and patients to make more informed treatment decisions. Although TRT does not seem to increase the risk of prostate cancer, careful patient selection and continuous monitoring are essential to ensure the safety and effectiveness of testosterone hormone treatment.
During Blue November, in addition to focusing on early diagnosis, raising awareness about treatments such as TRT and their impact on men’s health is essential to promote a more comprehensive and safe approach to men’s health.
Article written by Dr. Francisco Tostes, Scientific Director at Renewal.
