Low-grade prostate cancer has a good prognosis, with a five-year survival rate exceeding 99%. Although surgical treatment via radical prostatectomy is successful, this procedure can leave side effects including decreased sexual function, reduced physical performance, fatigue, and low mood in a significant number of patients.
In this context, a research team led by Dr. Shalinder Bhasin from Massachusetts General Hospital Brigham and Women’s Hospital conducted a randomized clinical trial to test the effect of testosterone replacement therapy on men with low hormone levels after surgery.
The study included 136 men aged 40 and older who had undetectable levels of prostate-specific antigen (PSA) for at least two years post-surgery, along with low testosterone. Participants were randomly assigned to receive either testosterone injections or a placebo weekly for 12 weeks, followed by an additional 12-week follow-up period.
The results, published in JAMA Internal Medicine, showed that testosterone treatment led to a significant improvement in sexual desire and activity, along with improved physical performance and quality of life indicators, compared to the placebo group. It also contributed to improved body composition and overall well-being among the participants.
In contrast, no significant change in erectile function was observed during the study period, and no cases of biochemical relapse—that is, an increase in PSA levels that may indicate cancer recurrence—were recorded in either group.
Dr. Bhasin said the study's findings suggest that testosterone use, previously thought to be unsafe for those with a history of prostate cancer, may be a promising option for improving sexual and physical function in some patients, while emphasizing the need for longer and broader studies to assess long-term safety.
It is reported that between 50% and 70% of men suffer from sexual and physical dysfunction after radical prostatectomy, and about a third experience a significant decrease in testosterone, making this type of treatment a subject of increasing research interest to improve their quality of life.
