Key clinical point: Most studies about the safety of exogenous testosterone replacement in patients with a history of prostate cancer (Pca) suggest that there is little risk, but physicians should continue to provide prostate specific antigen measurements and digital rectal examinations to these patients.

Major finding: 1 of 18 series of low total testosterone and PCa adhered to published guidelines while none of 17 showing a relationship of high total testosterone to PCa, and only 1 of 10 that identified no relationship between total testosterone and prostate cancer adhered to measurements recommended in the guidelines.

Study details: Forty-five articles from 1994-2014 related to the relationship between PCa and total testosterone were examined and summarized determining the risk of exogenous testosterone administration in patients already diagnosed, treated, or on active surveillance for PCa.