Urologist Prescribes AndroGel to Patient With Prostate Cancer

This case involves a fifty-three-year-old patient who presented to his urologist complaining of recent sexual dysfunction. He also complained of sleep disturbances, fatigue, and lower back pain. The urologist advised the patient that he may be suffering from low testosterone and would likely benefit from using AndroGel “trt,” or therapeutic testosterone cream. The physician only performed a physical exam on the patient but neglected to screen his blood for a baseline PSA value. Three months later, the patient returned with reports of improved sexual function but now complained of new urinary symptoms associated with occasional blood in the urine. Subsequently, the patient was found to have advanced prostate cancer.

Question(s) For Expert Witness

1. Does this medication increase a patient's risk for cancer?

Expert Witness Response E-000182

AndroGel is an androgen hormone indicated for replacement therapy in males for conditions associated with a deficiency or absence of endogenous testosterone. It is widely accepted in the medical community that patients treated with androgens may be at increased risk for prostate cancer and it is of utmost importance to evaluate patients for possible prostate cancer prior to initiating and during treatment with androgen therapy. It is negligent to blindly prescribe this medication without first screening a patient and determining a baseline PSA.