Testosterone Therapy in Men with Advanced Prostate Cancer: Too Many Unknowns for Safe Use.

Accepted practice surrounding the use of exogenous testosterone in the presence of treated or untreated localized prostate cancer has changed dramatically over the past decade. Recent evidence has failed to show an increased risk of de novo disease in the general population,1 or of progression or recurrence in men after definitive therapy or on active surveillance for localized disease.2 This has culminated in recent American Urological Association guidelines on testosterone therapy (TT) reinforcing the lack of evidence connecting TT to de novo prostate cancer, and supporting the safety of TT in men with treated prostate cancer— primarily in men with low or intermediate risk disease.1