How to cite: Morgentaler A. “State-of-the-Art: Is Testosterone the King?” Grand Rounds in Urology. August 2026. Accessed Oct 2026. https://grandroundsinurology.com/state-of-the-art-is-testosterone-the-king/
Summary
In this presentation from the UroCancer Interdisciplinary Forum 2026, Abraham Morgentaler, MD, FACS, Professor of Urology, Harvard University and Men’s Health Boston, Boston, Massachusetts, argues that traditional beliefs regarding testosterone and prostate cancer are unsupported by contemporary evidence. He describes his own clinical experience treating men with testosterone deficiency and the observations that led him to question the prevailing belief that testosterone inevitably stimulates prostate cancer growth.
Dr. Morgentaler traces the evolution of testosterone therapy following the work of Charles Huggins. He explains how contemporary studies, including the TRAVERSE trial, large biopsy cohorts, randomized clinical trials, and epidemiologic data, have challenged traditional assumptions regarding prostate cancer risk. He also introduces the saturation model and the concept of androgen adequacy, which provide a biological framework for understanding why physiologic testosterone replacement may not continuously stimulate prostate tissue.
Dr. Morgentaler shares early clinical experience using testosterone therapy in carefully selected men with advanced prostate cancer, including illustrative patient cases and discussion of bipolar androgen therapy concepts. While acknowledging that prospective clinical trials remain necessary, he argues that current evidence supports reexamining historical restrictions on testosterone therapy and encourages further investigation into its role across the prostate cancer continuum.
ABOUT THE AUTHOR
Abraham Morgentaler, MD, FACS, graduated from Harvard College in 1978 and Harvard Medical School in 1982. Dr. Morgentaler completed his residency in 1988 through the Harvard Program in Urology, and then joined the faculty of Beth Israel Deaconess Medical Center and Harvard Medical School. He is currently an Associate Clinical Professor of Surgery (Urology) at Harvard Medical School. In 1999, Dr. Morgentaler founded Men's Health Boston, the first center in the US to focus on sexual, reproductive, and hormonal health for men. Dr. Morgentaler was the recipient of the New Investigator Award in 1994 granted by the American Foundation of Urological Disease.
