Testosterone Therapy [TTh] & PCa

[pjoshea13]

New study below [1].

"We conducted a retrospective cohort study of 189,491 men aged 40-60 years old in the IBM MarketScan® Commercial Database, which included 1,424 PCa cases diagnosed from 2011 to 2014. TTh was defined using CPT codes from inpatient and outpatient, and NDC codes from pharmacy claims."

"We found a 33% reduced association of PCa after comparing the highest category (>12) of TTh injections with the lowest (1-2 injections)"

"Similar statistical significant inverse association for PCa was observed for men who received TTh topical gels (>330 versus 1-60 days' supply)."

"Conclusion Overall, increased use of TTh is inversely associated with PCa and this remained significant only among non-diabetics."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/314...

Clin Endocrinol (Oxf). 2019 Sep 9. doi: 10.1111/cen.14093. [Epub ahead of print]

Association of the extent of therapy with prostate cancer in those receiving testosterone therapy in a US commercial insurance claims database.

Lopez DS1, Huang D1, Tsilidis KK2,3, Khera M4, Williams SB5, Urban R6, Orestis P7, Kuo YF1, Baillargeon J1, Farias A8, Krause T9.

Author information

1

Deparment of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA.

2

Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.

3

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

4

Scott Department of Urology, Baylor College of Medicine, Houston, TX.

5

Department of Surgery, Division of Urology, University of Texas Medical Branch, Galveston, TX, USA.

6

Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX.

7

Department of Policy and Practice, Brown University, School of Public Health, Providence, RI.

8

Keck School of Medicine, University of Southern California, Department of Preventive Medicine, Norris Comprehensive Cancer Center, Gehr Family Center for Health Systems Science.

9

UTHealth School of Public Health, Houston, TX.

Abstract

BACKGROUND:

Conflicting evidence remains in the association of testosterone therapy (TTh) with prostate cancer (PCa). This inconsistency maybe due, in part, to the small sample sizes from previous studies and an incomplete assessment of comorbidities, particularly diabetes.

OBJECTIVE:

We investigated the association of PCa with TTh (injection or gel) and different TTh doses, and determined whether this association varies by presence of diabetes at baseline in a large, nationally representative, commercially insured cohort.

DESIGN:

We conducted a retrospective cohort study of 189,491 men aged 40-60 years old in the IBM MarketScan® Commercial Database, which included 1,424 PCa cases diagnosed from 2011 to 2014. TTh was defined using CPT codes from inpatient and outpatient, and NDC codes from pharmacy claims. Multivariable adjusted Cox proportional hazards models were used to compute hazard ratios for patients with incident PCa.

RESULTS:

We found a 33% reduced association of PCa after comparing the highest category (>12) of TTh injections with the lowest (1-2 injections) category (HR = 0.67, 95% CI: 0.54-0.82). Similar statistical significant inverse association for PCa was observed for men who received TTh topical gels (>330 versus 1-60 days' supply). Among non-diabetics we found significant inverse association between TTh (injection and gel) and PCa, but a weak interaction between TTh injections and diabetes (P = 0.05). Conclusion Overall, increased use of TTh is inversely associated with PCa and this remained significant only among non-diabetics. These findings warrant further investigation in large randomized placebo-controlled trials to infer any health benefit by TTh.

© 2019 John Wiley & Sons Ltd.

KEYWORDS:

health claims data and diabetes; prostate cancer; testosterone therapy

PMID: 31498469 DOI: 10.1111/cen.14093

[cesces]

So you should treat prostate cancer by either increasing or decreasing testosterone levels?

[pjoshea13 in reply to cesces]

I think that men on active surveillance who have low T levels might benefit from TTh.

-Patrick

[Tommyj2 in reply to pjoshea13]

Know any MD's that would be willing to experiment with this?? As it flies in the fact of " best practices" I'm thinking no : )..... I am still awaiting my doubling time to reduce to 6 months before beginning ADT..... wouldn't it be terrific if additional T ( I have relatively low T in the 300's) helped to forestall this event....

[pjoshea13 in reply to Tommyj2]

I have known a few men who have been treated by Dr. Morgentaler. I don't his criteria for doing so.

-Patrick

[Tommyj2 in reply to pjoshea13]

Don't know of him... where is he located?? Institution affiliation?

[Schwah]

So “why does adt even work for APC” is the question this brings to mind. And does it actually extend lives. Obviously that’s the conventional wisdom. I’ve seen a lot of studies combing adt with chemo or Zytega improving live spans vs adt alone. Can’t find any studies showing adt alone bs placebo

(Or even added testosterone) actually extends our lives. I did it of course but these studies always make me ponder.

Schwah