NEW YORK (Reuters Health) Jan 02 - Testosterone replacement therapy
does not increase the risk of prostate cancer in men with prostatic
intraepithelial neoplasia, according to a study in the December
issue of The Journal of Urology.

Drs. Ernani Luis Rhoden and Abraham Morgenthaler of the Beth Israel
Deaconess Medical Center in Boston, Massachusetts explain that
because prostate cancer is hormonally responsive, physicians have
been afraid to provide testosterone replacement therapy to men who
have a history of prostatic intraepithelial neoplasia, considered to
be a precancerous lesion.

The authors write that at their medical center, prostate biopsies
are routinely done in men who are about to receive testosterone
replacement therapy.

They report in their paper on 75 hypogonadal men who completed 12
months of testosterone replacement therapy. Twenty men had prostatic
intraepithelial neoplasia; and the remaining 55 had benign biopsies.

According to the article, prostate specific antigen levels were
similar in both groups both at baseline and after 12 months of
treatment.

One patient in the prostatic intraepithelial neoplasia group and
none in the benign biopsy group developed cancer. The authors point
out that because prostate cancer develops within 3 years in up to a
quarter of patients with prostatic intraepithelial neoplasia, "it
would be difficult to implicate testosterone replacement therapy as
an etiological factor."

"After 1 year of testosterone replacement therapy men with prostatic
intraepithelial neoplasia do not have a greater increase in prostate
specific antigen or a significantly increased risk of cancer than
men without prostatic intraepithelial neoplasia," the investigators
conclude. "These results indicate that testosterone replacement
therapy is not contraindicated in men with a history of prostatic
intraepithelial neoplasia."

J Urol 2003;170:2348-2351.