The Prostate Myth: Does TRT Increase Cancer Risk?

You are sitting in the doctor’s office. You are tired. You have gained weight. Your sex drive is gone. You ask about Testosterone Replacement Therapy (TRT). 

The doctor hesitates. “Well,” they say, “we have to be careful. You don’t want to get prostate cancer.” 

This single sentence stops millions of men from getting the treatment they need. It creates a fear that is deep and visceral. 

But here is the truth: 

That doctor is wrong. 

The idea that testosterone therapy prostate cancer risk is high is based on old science. Specifically, it is based on one study from 1941. That study won a Nobel Prize. But it was also misinterpreted for 70 years. 

Today, urologists and oncologists know better. The modern consensus is clear: TRT does not cause prostate cancer. In fact, low testosterone might be more dangerous. 

At Nava Health, we base our protocols on current evidence, not outdated myths. Here is the science behind why TRT is safe for your prostate, and how we monitor you to keep it that way. 

The Origin of the Myth: The Huggins Study (1941) 

To understand the fear, you have to go back to 1941. 

Dr. Charles Huggins discovered that if you castrated men with metastatic prostate cancer (removed their testicles), the cancer shrank. This proved that prostate cancer cells “feed” on testosterone. 

This was a huge discovery. He won the Nobel Prize for it. 

However, doctors made a logical leap that turned out to be false. They assumed: “If removing testosterone shrinks cancer, then adding testosterone must cause cancer.” 

They called this “Fuel on the Fire.” 

For decades, this was medical dogma. No doctor would give testosterone to a man for fear of starting a fire. 

The New Science: The Saturation Model 

Fast forward to the 2000s. Researchers started looking closer. 

Dr. Abraham Morgentaler at Harvard University reviewed decades of data. He found something shocking: Men with high testosterone did not have higher rates of prostate cancer. 

In fact, men with low testosterone often had more aggressive cancers. 

How could this be? 

He proposed the Saturation Model. 

Imagine a House Plant 

Think of your prostate like a house plant. It needs water (testosterone) to survive. If you stop watering it, it shrivels up. This is why castration works for cancer. 

But once the plant is fully watered, adding more water doesn’t make it grow into a giant beanstalk. The soil can only hold so much water. 

The prostate is the same. It has receptors for testosterone. Once those receptors are full (saturated), adding more testosterone does nothing. 

The saturation point is very low. It happens at levels around 250 ng/dL. Most men, even those with low T are already above this saturation point. 

So, raising your testosterone from 300 to 800 does not “feed” the cancer any more than it already was. The receptors are already full. 

What About BPH (Enlarged Prostate)? 

Many men worry about Benign Prostatic Hyperplasia (BPH). This is when the prostate grows and makes it hard to pee. 

Does TRT make BPH worse? 

Actually, evidence suggests bph and testosterone have an inverse relationship. 

The prostate tends to grow as men age. But testosterone levels drop as men age. If testosterone caused growth, shouldn’t the prostate shrink as you get older? 

Studies show that treating men with TRT often improves urinary symptoms. Why? Because testosterone reduces inflammation in the prostate and improves bladder muscle strength. 

Many men report they pee better on TRT, not worse. 

PSA Levels on TRT: What to Expect 

This is where monitoring comes in. 

PSA (Prostate Specific Antigen) is a protein made by the prostate. High levels can indicate cancer, infection, or just enlargement. 

When you start TRT, your PSA might rise slightly. This is normal. The prostate is “waking up” and getting healthier blood flow. 

However, we watch for velocity. 

• Safe: PSA goes from 1.0 to 1.2 and stays there. This is fine. 

• Dangerous: PSA goes from 1.0 to 2.5 in six months. This is a spike. 

If we see a rapid spike, we stop therapy and refer you to a urologist. This is why being on TRT is actually safer than not being on it. 

Think about it: Most men ignore their prostate until it hurts. Men on TRT get their PSA checked every 6 months. If you develop cancer, we will catch it earlier than anyone else. 

The Risk of Low Testosterone 

We spend so much time worrying about the risk of treatment that we ignore the risk of doing nothing. 

Low testosterone is not safe. It is a major health risk. 

Men with low T have higher rates of: 

• Aggressive (High-Grade) Prostate Cancer. 

• Heart Disease. 

• Diabetes. 

• Alzheimer’s Disease. 

• Early Death. 

By fearing TRT, you might be trading a theoretical risk for a very real one. 

Comparison: The Old Fear vs. The New Reality 

Let’s look at how the medical consensus has shifted. 

Nava’s Safety Protocol: We Don’t Guess 

At Nava Health, we take your safety seriously. We don’t just hand out testosterone. 

We follow a rigorous screening process:

1. Baseline PSA and Exam

Before you start, we check your PSA. If it is elevated (>4.0 ng/mL), we refer you to a urologist for clearance first. We do not treat active cancer without oncologist approval.

2. The 6-Month Monitor

We check your PSA and blood counts every 6 months. This is non-negotiable.

3. Estrogen Management

High estrogen can irritate the prostate. By balancing your hormones (not just T, but E as well), we keep the prostate environment healthy.

4 The Active Surveillance Advantage

Because you are in our care, you are being watched. If any issue arises—prostate or otherwise, we catch it early. This is “active surveillance.”