Low Testosterone Linked to Higher Cancer Risk, Study Suggests
A meta-analysis published in *The Lancet* found that men with very low testosterone levels face a greater risk of developing cancer and dying from the disease, according to a study combining data from 11 studies involving 24,500 participants. The research, which adjusted for factors like age and lifestyle, showed that low testosterone was associated with increased cancer risk but not specifically prostate cancer. “This isn’t a small study with a tidy conclusion that falls apart under scrutiny,” said Rohit Gosain, M.D., medical director at Roswell Park Comprehensive Cancer Center and co-host of The Oncology Brothers podcast.
What the Study Found
The study analyzed testosterone levels and cancer outcomes over a 5-year period, revealing that men with the lowest baseline testosterone concentrations had higher cancer incidence and mortality rates. However, the link was not specific to prostate cancer, contradicting common assumptions about testosterone and prostate cancer. Instead, lower levels of sex hormone-binding globulin (SHBG) and luteinising hormone (LH) were tied to a higher prostate cancer risk. “It’s a significant finding because it suggests testosterone may be doing more in the body than we typically credit it for,” Gosain said.
Understanding the Link
While the study found a correlation, it did not prove causation. Amar Rewari, M.D., chief of radiation oncology at Luminis Health and adjunct assistant professor at Johns Hopkins School of Medicine, noted that low testosterone might reflect underlying health issues rather than directly causing cancer. Testosterone’s role in regulating immune function, inflammation, and body composition could explain the connection. “When levels drop, you tend to see more visceral fat, insulin resistance, and chronic low-grade inflammation. These are all known contributors to cancer risk,” Gosain explained.
How to Detect and Treat Low Testosterone
Experts advise against routine screening for low testosterone unless symptoms are present. “Current guidelines still recommend testing men who have symptoms of testosterone deficiency, such as low libido, erectile dysfunction, fatigue, decreased muscle mass, or osteoporosis, rather than screening everyone,” Rewari said. If levels are consistently low, further bloodwork is needed to identify the cause. Testosterone replacement therapy (TRT) is an option for those with severe symptoms but is not a first-line treatment. “Significant improvements can often be achieved through weight management, regular exercise, adequate sleep, and stress reduction,” said Christopher Koller, M.D., urologic oncologist at Hackensack University Medical Center.
Key Takeaways
– Low testosterone is linked to higher cancer risk but not specifically prostate cancer.
– The study highlights testosterone and related hormones as potential biomarkers for cancer risk.
– Routine screening is not recommended; testing should be based on symptoms.
– Lifestyle changes are often the first step in managing low testosterone.
– TRT carries risks and should be discussed with a healthcare provider.
What You Should Know About Cancer Prevention
While the study underscores the importance of hormonal health, well-established cancer prevention strategies remain critical. These include maintaining a healthy weight, exercising regularly, avoiding tobacco, limiting alcohol, and staying up to date with recommended cancer screenings. “The interventions with the strongest evidence remain maintaining a healthy weight, exercising regularly, avoiding tobacco, limiting alcohol, and staying up to date with recommended cancer screenings,” Rewari said.
Next Steps for Men Concerned About Testosterone Levels
Men experiencing symptoms of low testosterone should consult their healthcare provider for personalized advice. “If your testosterone is chronically low, it may be worth asking your doctor whether that warrants a closer look at your overall health picture,” Gosain said. However, Rewari noted, “This study should not be interpreted as evidence that testosterone replacement prevents cancer, because it did not study treatment.”