Letter to the Editor
Re: Testosterone treatment is not associated with increased risk of prostate cancer or worsening of lower urinary tract symptoms: Prostate health outcomes in the Registry of Hypogonadism in Men (RHYME)
The paper by Frans M.J. Debruyne et al published July 2016 is very interesting . With data from 999 hypogonadism (HG) patients and followed up for 24 months, this study demonstrated again that testosterone replacement therapy (TRT) is not associated with any increased risk of prostate cancer. Findings of this study may also help clarify the decades-long controversy regarding the relationship between testosterone and risk of prostate cancer. As referred by the authors, many researchers believe that it is the rapid decline rather than the current level of testosterone that might have contributed to the prostate cancer risk . If this hypothesis is true, there is no risk at least in theory to provide TRT for HG patients because the treatment will help these patients to restore their hormone levels. However, we do have one question for the authors: although this study did not find any TRT-related risk for prostate cancer, PSA levels were positively and significantly associated with TRT. Although the PSA levels for the HG patients who received TRT remained in normal range (<4.0 ng/ml) by the end of the study period, we cannot ignore potential risks since PSA is a significant predictor of prostate cancer. We would like to know authors’ interpretations for this finding.
Conflict of interest statement
We have no conflict of interest to declare.
 Debruyne FM, Behre HM, Roehrborn CG, et al. Testosterone treatment is not associated with increased risk of prostate cancer or worsening of lower urinary tract symptoms: prostate health outcomes in the Registry of Hypogonadism in Men. BJU international. 2016 Jul 13:
 Xu X, Chen X, Hu H, Dailey AB, Taylor BD. Current opinion on the role of testosterone in the development of prostate cancer: a dynamic model. BMC cancer. 2015: 15:806
Kai Wang and Xinguang Chen
Department of Epidemiology, University of Florida
2004 Mowry Road, Gainesville, FL, 32610