- Low testosterone is a common condition among middle-aged and older men.
- Scientists have uncovered a link between low testosterone and increased cancer risk.
- Doctors suggest consulting with your healthcare provider if you’re having symptoms of low testosterone.
When you hear the phrase “low testosterone,” you might think about low libido or fatigue. But men with low testosterone—known colloquially as “low T,” and as “male hypogonadism” in the medical community—have more to worry about than the symptoms generally associated with the common condition. According to the Cleveland Clinic, it can increase the risk of osteoporosis or heart and blood vessel disorders. And now, a new study has linked low testosterone in men to an increased risk of cancer.
Below, oncologists weigh in on the findings, explain the potential connection between low testosterone and cancer, and share their thoughts on detecting and treating the hormonal deficiency.
Meet the Experts: Rohit Gosain, M.D., medical director at Roswell Park Comprehensive Cancer Center and co-host of The Oncology Brothers podcast; Amar Rewari, M.D., chief of radiation oncology at Luminis Health and adjunct assistant professor at Johns Hopkins School of Medicine; and Christopher Koller, M.D., urologic oncologist at Hackensack University Medical Center.
What did the study find?
The study, published in The Lancet, was a comprehensive meta-analysis that pooled data from 11 studies with a combined total of 24,500 participants. Scientists looked at the men’s testosterone levels and their likelihood of receiving a cancer diagnosis or dying from cancer over a 5-year period. Data were then adjusted for confounding factors like age and lifestyle habits.
The researchers found that men with very low baseline testosterone concentrations were more likely to both develop cancer and die from cancer, whereas normal testosterone levels were associated with lower cancer risk. Importantly, low testosterone was not associated with increased risk of prostate cancer specifically. (There is a common belief that testosterone and prostate cancer are linked, which these findings suggest is false.) Instead, a higher risk of prostate cancer diagnosis was associated with lower levels of sex hormone-binding globulin (SHBG) and luteinising hormone (LH).
“It’s a significant finding because it suggests testosterone may be doing more in the body than we typically credit it for,” says Rohit Gosain, M.D., medical director at Roswell Park Comprehensive Cancer Center and co-host of The Oncology Brothers podcast. “This isn’t a small study with a tidy conclusion that falls apart under scrutiny,” he adds. “The breadth of the data is part of what makes it worth paying attention to.”
Overall, the findings suggest that the studied hormones “may be important biomarkers for cancer risk and mortality,” says Christopher Koller, M.D., urologic oncologist at Hackensack University Medical Center.
What’s behind the link?
To be clear, the study only found a correlation between low testosterone and cancer risk—it didn’t find that having low testosterone caused cancer. In fact, while experts don’t fully understand how the two are connected, Dr. Gosain believes it’s possible that rather than causing cancer, low testosterone simply points to “something already going wrong in the body.” He continues, “In middle-aged and older men, low levels can signal reduced physical resilience and underlying health conditions that don’t always announce themselves otherwise.”
On the other hand, testosterone helps regulate immune function, body composition, and inflammation—so its absence can have consequences. “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. It’s less a single cause and more a cluster of conditions that can compound over time,” Dr. Gosain says.
How to detect and treat low testosterone
These findings may have you curious about checking your testosterone levels or inquiring about hormone replacement therapy, but oncologists suggest taking it slow—especially if you’re not showing signs of the condition. “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,” says Amar Rewari, M.D., chief of radiation oncology at Luminis Health and adjunct assistant professor at Johns Hopkins School of Medicine.
If you and your healthcare provider do decide to test your hormones, don’t expect overnight results. A fasting morning blood draw must be collected on at least two separate occasions, notes Dr. Gosain. “A single low reading isn’t enough to act on, and if levels consistently come back low, the next step is additional bloodwork to understand where the issue is coming from,” he adds.
If you do have low levels and are suffering from bothersome symptoms, a doctor may prescribe testosterone replacement therapy (TRT). However, “it’s not a first-line response to a number on a lab report,” Dr. Gosain says. A physician will likely recommend lifestyle changes before TRT, as TRT comes with its own potential risks, including fertility issues and potential cardiovascular effects, Dr. Koller says. “Significant improvements can often be achieved through weight management, regular exercise, adequate sleep, and stress reduction,” he adds.
Crucially, Dr. Rewari notes, “This study should not be interpreted as evidence that testosterone replacement prevents cancer, because it did not study treatment.”
The bottom line
“Low testosterone is shaping up to be a meaningful signal for cancer risk and mortality,” says Dr. Gosain. “If your testosterone is chronically low, it may be worth asking your doctor whether that warrants a closer look at your overall health picture.”
Even so, well-studied methods for cancer prevention should take priority over any treatments specific to low testosterone. “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,” says Dr. Rewari.
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