In his book, Testosterone for Life, Dr. Morgentaler recounts how it takes years, even decades, to correct a medical myth.
In this case, the medical establishment's misconception about testosterone and prostate cancer has condemned millions of aging men to suffer degenerative diseases caused by testosterone deficiency.
Until just a few years ago, it was almost universally believed that testosterone therapy would lead to some degree of increased risk of prostate cancer.
During that time testosterone therapy was seen to represent the proverbial pact with the devil, by trading short-term sexual and physical rewards for the ultimate development of a malignant cancer.
Fortunately, this belief has been shown to be incorrect, and medical opinion has begun to shift quite dramatically, with good evidence that testosterone therapy is quite safe for the prostate.
There is even now a growing concern that low testosterone is a risk for prostate cancer rather than high testosterone.
This makes complete sense since it is not the young men whose testosterone levels are optimal who are getting prostate cancer.
The men who get prostate cancer tend to be older men who have low testosterone levels and high estrogen levels.
These men also get more aggressive prostate cancer the lower their testosterone level is.
How the original fear about testosterone and prostate cancer came to be is an amazing story involving Nobel Prize winners, medical breakthroughs, and a critical paradox that took two-thirds of a century to solve.
In the end, it is also a cautionary tale of how it may take years-even decades-to correct a medical "truth" once it has been established.
The relationship of testosterone to prostate cancer has undergone a significant reevaluation.
It is still very important to be properly evaluated and closely monitored while receiving testosterone replacement therapy.
Dr. Morgentaler studied 13 men with scores of 6 or 7 on the 10-point Gleason scale, indicating mildly to moderately aggressive prostate cancer.
They all initially chose watchful waiting rather than treatment for their cancers.
All the men had low testosterone levels.
The men received testosterone therapy for an average of two and a half years, and had periodic prostate biopsies.
None of their cancers progressed or spread to other organs.
One subject whose score had increased to 7 from 6 had his prostate removed, but the final pathological exam found no aggressive disease.
The authors acknowledge that the study, published in the April issue The Journal of Urology, was small and retrospective. Still, it is the first to use biopsies to monitor the effects of testosterone in men with untreated, localized prostate cancer.
The lead author, Dr. Abraham Morgentaler, an associate clinical professor of surgery at Harvard, said that the findings of this and other recent studies suggest that the risks of testosterone therapy may have been exaggerated.
