With Dr. Abraham Morgentaler and Dr. Marianne Brandon

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In this episode, Dr. Brandon & Dr. Morgentaler discuss how testosterone therapy affects cholesterol, challenge long-held beliefs about prostate cancer treatment, and explore why some of medicine's biggest assumptions may deserve a second look.

00:00 – Podcast Kickoff: The episode opens with a listener question about how oral testosterone may affect cholesterol and heart health.

00:50 – Oral Testosterone Lipids: Dr. Morgentaler explains what testosterone therapy really does to cholesterol, ApoB, and overall cardiovascular risk.

06:29 – Conference ADT Debate: Fresh from a cancer conference, Dr. Morgentaler questions why androgen deprivation therapy remains the standard treatment.

22:41 – Why ADT Comes First: The doctors discuss why ADT is still used first despite newer therapies that may offer greater benefits.

24:54 – BAT and PSA Confusion: They break down bipolar androgen therapy (BAT) and explain why PSA levels don't always tell the full story.

32:28 – Huggins Myth and Wrap Up: Dr. Morgentaler revisits the decades-old research that shaped testosterone's reputation in prostate cancer and why it's worth questioning today.

Resources:
Huggins C, Hodges CV. Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate. Cancer Research. 1941;1:293-297.
Morgentaler A, Rhoden EL. Prevalence of Prostate Cancer Among Hypogonadal Men With Prostate-Specific Antigen Less Than 4.0 ng/mL and Normal Digital Rectal Examination: Results of a Biopsy Study. The Journal of Urology. 2006;175(2):495-499.
Morgentaler A, Rhoden EL. Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring. New England Journal of Medicine. 2004;350:482-492.
Tombal B, et al. The EMBARK Trial: Enzalutamide in Patients With High-Risk Biochemically Recurrent Prostate Cancer. New England Journal of Medicine. 2023.
Denmeade SR, et al. Bipolar Androgen Therapy for Men With Castration-Resistant Prostate Cancer. (Johns Hopkins series of clinical trials and publications on BAT.)

#testosteronetherapy #prostatecancertreatment #medicalinnovation