Have you been diagnosed with low T and are you on testosterone replacement therapy (TRT)?

Do you know if you are at risk for prostate cancer or are on Active Surveillance (AS)?

Have you been treated for prostate cancer in the past?

If you answered yes to any of these, it will interest you to learn that multiparametric MRI can be vital in confirming the safety and effectiveness of TRT for prostate cancer patients with hypogonadism.

Low T, Testosterone Replacement, and Prostate Cancer

About 20% of men over age 60 have low T – the same age at which the risk for prostate cancer (PCa) begins to rise. It was long held that PCa patients with low T could not take advantage of testosterone replacement therapy because it could fuel tumor progression and growth. We now know those early studies were flawed.

Today, a growing body of work shows that TRT is safe for hypogonadal PCa patients. For example, a 2015 study out of Men’s Health Boston showed that men on active surveillance who were on testosterone replacement therapy had no greater disease growth or progression than AS patients not on TRT. Also, a presentation at the 2016 Canadian Urological Association meeting reported that TRT was safe for PCa patients with low T. The study cohort included 8 PCa patients on active surveillance, 50 who had radiation therapy, 22 who had prostatectomy, 1 cryotherapy case, and 1 HIFU case. The results from a median follow-up of 41 months showed an increase in testosterone and PSA (which normally occurs with TRT) but no progression of PCa on biopsy. The study concluded that testosterone replacement therapy is safe for PCa patients regardless of treatment.

mpMRI is Far Superior to PSA for Monitoring Prostate Cancer Patients on Testosterone Replacement Therapy

Now, a new multiparametric MRI (mpMRI) imaging study from Memorial Sloane Kettering Cancer Center supports TRT patient safety and how to monitor it. Besides confirming that TRT boosts testosterone without aggravating prostate cancer, The MSK team proved that mpMRI can monitor patients on TRT during AS. In fact, mpMRI detected disease progression in 2 men (attributed to the natural history of prostate cancer but not TRT). Dr. Herbert Vargas, a study author, said that “validated mpMRI may help the clinician to monitor patients treated with TRT even if PSA elevation is observed while on AS.”

The Sperling Prostate Center offers powerful, state-of-the-art mpMRI for the detection, diagnosis and treatment of prostate cancer. With the ability of mpMRI to distinguish prostate zonal anatomy, healthy tissue, and prostate disease states (benign or malignant), it is the ideal imaging modality to monitor gland changes related to TRT, prostate cancer, or a combination of the two. Our expert services include scan interpretation by international expert Dr. Dan Sperling.