By Jeremiah Velasquez, FNP-BC, AGACNP-BC
Founder, Steel City HRT & Weight Loss | Board-Certified Family & Acute Care Nurse Practitioner
NPI: 1841894003

The 2023 TRAVERSE trial — the largest randomized controlled trial ever conducted on testosterone replacement therapy safety — enrolled 5,246 men across 14,304 person-years of follow-up and found no statistically significant increase in prostate cancer incidence in men treated with TRT versus placebo. For appropriately screened men in Arizona, the data no longer supports withholding testosterone therapy over prostate cancer fear.

If You've Been Told Testosterone Causes Prostate Cancer, Listen to What the Data Actually Says

If you've ever been told that testosterone therapy will accelerate prostate cancer — by your primary care doctor, a urologist, or someone passing advice at the gym — you were handed a piece of medical mythology that's now been definitively answered by the largest clinical trial ever run on this subject.

For decades, men in Gilbert, Arizona and across the country have walked away from conversations with their providers carrying the same warning: testosterone feeds cancer. It sounds clinical. It sounds certain. And it was built almost entirely on a study from 1941 that followed three patients — one of whom had already been surgically castrated.

That's not a foundation. That's a case report.

In 2023, the TRAVERSE trial — a five-thousand-man, fourteen-thousand person-year randomized controlled trial — answered the prostate safety question with the kind of data that cannot be dismissed, cherry-picked, or explained away. And the answer was precisely the opposite of what the anti-TRT medical consensus had been predicting for eight decades.

You've been told no long enough. Here's what the evidence actually says.

Why Have Men Been Told TRT Is Dangerous for the Prostate?

You know something is off — not just about your energy or your drive, but about the conversation you walked away from. Your provider isn't wrong. The system is.

Testosterone deficiency — clinically defined as consistently low serum testosterone, typically below 300 ng/dL, combined with symptoms of hypogonadism — affects a substantial portion of adult men. Testosterone is the primary male androgen responsible for energy, libido, lean muscle mass, mood, and cognitive clarity. When levels fall, the effects are not subtle.

But when men in Arizona bring up testosterone optimization, the reflex response from many primary care providers still traces back to 1941. That year, researchers Huggins and Hodges published findings suggesting testosterone accelerated prostate cancer. The conclusion that made it into medical textbooks for the next eighty years was based on the response of a single castrated patient given exogenous testosterone. One data point. No control group. A fourteen-day observation window.

The foundational claim that shaped how an entire generation of providers treated men was not evidence — it was anecdote codified into dogma.

Here's what that creates in practice:

One. Men experiencing low drive, brain fog, and physical decline are told to manage it naturally. Two. Providers dismiss symptoms as aging rather than investigating hormonal status. Three. Men with laboratory-confirmed testosterone deficiency are refused treatment because a provider fears a cancer risk the evidence does not support. Four. Men who most need optimization spend years performing at a fraction of their potential — showing up as half the husband, father, and professional they used to be.

You weren't imagining it. The system made it easier not to treat you.

Key takeaway: The historic fear that TRT accelerates prostate cancer originates from a methodologically insufficient 1941 case study involving one castrated patient — not the rigorous evidence that has since emerged over eight decades of modern research.

What Does the Saturation Model — and the TRAVERSE Trial — Actually Show?

Here's what most people don't know: the prostate doesn't respond to testosterone in a linear, unlimited way. It saturates.

Dr. Abraham Morgentaler introduced the Saturation Model in 2007, and it fundamentally changed how urologists and endocrinologists understand the relationship between testosterone and prostate tissue. The model demonstrates that the prostate's androgen receptors reach a functional maximum at a surprisingly low concentration — approximately 230 ng/dL of total serum testosterone. Think of it like a sponge. Once it's saturated, you can pour more water on it. The sponge cannot absorb any more. Beyond that threshold, additional testosterone has no further biological effect on prostatic tissue.

This explains the paradox that puzzled clinicians for decades: why castration dramatically shrinks prostate tumors (by pulling testosterone below the saturation threshold), while men with normal or high-normal testosterone don't show elevated cancer rates. According to a landmark analysis of 2,967 men published in the peer-reviewed literature and cited in support of the Saturation Model, baseline PSA levels showed no correlation with serum testosterone when testosterone was within the normal range — only in men with severe testosterone deficiency.

Then came TRAVERSE.

Published in JAMA Network Open in 2023, the TRAVERSE trial enrolled 5,246 men aged 45 to 80 with pre-existing cardiovascular disease or elevated cardiovascular risk — arguably the highest-risk population a researcher could select. Over 14,304 person-years of follow-up, with a mean follow-up of 33 months, the trial found no statistically significant difference in prostate cancer incidence between men receiving testosterone gel and men receiving placebo. PSA did rise modestly in the TRT group — which is exactly what the Saturation Model predicts. Hypogonadal men moving from sub-saturated to saturated androgen receptor states show a physiological PSA increase. That increase did not translate into clinical malignancy.

If testosterone were genuinely carcinogenic to the prostate, TRAVERSE would have caught it.

It didn't.

Explore how Steel City HRT & Weight Loss approaches evidence-based testosterone therapy in Arizona — including the PSA monitoring protocol built into every patient's care cycle.

Key takeaway: The 2023 TRAVERSE trial — the largest TRT safety RCT ever conducted — found no statistically significant increase in prostate cancer in men using TRT versus placebo, confirming the Saturation Model's prediction that physiological testosterone levels do not drive prostatic malignancy.

What Does This Mean for Men in Arizona Who Are Considering TRT?

The burden of proof has flipped.

For decades, men had to justify testosterone therapy in the face of theoretical cancer risk. TRAVERSE inverts that equation. The question is no longer "is it safe to consider TRT?" The question is now "what is the actual cost of leaving a treatable hormonal deficiency untreated?"

That answer is increasingly uncomfortable. According to a study published in Oncology Letters, men with testosterone below 300 ng/dL carried a 5.6-fold increased risk of high-grade prostate cancer, a 72.4-fold increased risk of metastatic disease at the time of diagnosis, and a 10.7-fold increased risk of prostate cancer-specific mortality compared to men with normal testosterone levels. The American Urological Association has issued a Grade B recommendation stating there is no evidence linking TRT to prostate cancer development — and that men who have been successfully treated for low-grade, localized prostate cancer should be considered for TRT on an individualized basis.

The real danger isn't testosterone. It's the low-androgen environment that may selectively breed more aggressive, treatment-resistant cancer phenotypes.

Effective TRT for men in Arizona starts with a structured evaluation process. Starting with a comprehensive hormone panel and PSA baseline to establish your clinical picture, followed by a telehealth consult where symptoms, lab context, and individual risk factors are reviewed together, and ending with an individualized protocol delivered to your door — not a template built for the average. Men in Gilbert and Queen Creek don't need to drive anywhere, wait in a clinic, or hope their primary care provider happens to be current on 2023 data.

You've got two options. Keep chalking up your declining drive, poor sleep, and mental fog to aging — or start a conversation grounded in the best clinical evidence available.

Key takeaway: The AUA's Grade B recommendation affirms that TRT does not cause prostate cancer in appropriately screened men, while emerging data on the Low T Paradox suggests that untreated testosterone deficiency may itself carry significant oncological risk.

Why Are Arizona Men Choosing Steel City HRT & Weight Loss for Testosterone Optimization?

I have been on both sides of that table. I've been the patient told his numbers were "fine" while every system in his body was signaling otherwise. And I've been the provider who, early in training, repeated the same prostate warning I'd been handed — before I read the actual source material and realized what it was built on.

Steel City HRT & Weight Loss is LegitScript-certified — the highest compliance standard in telehealth, confirming that our clinical practices are medically legitimate, legally sound, and fully transparent. We are licensed and actively treating patients in Arizona, with no clinic visit required at any stage.

As a board-certified nurse practitioner, Jeremiah Velasquez, FNP-BC, AGACNP-BC built Steel City around one operating principle: your optimization is driven by your data, not a population average. PSA is monitored at every lab interval — because that's how you catch what's worth catching, and how you separate a physiological saturation response from a clinical signal that warrants further investigation.

We don't treat lab values. We treat you. Starting with labs, followed by a provider consult where every number gets context, and ending with an individualized protocol managed through our HIPAA-secure app — with direct access to your care team at every step.

Programs available in Arizona include testosterone replacement therapy, women's HRT, GLP-1 metabolic optimization, and peptide therapy. All medications sourced exclusively from 503a compounding pharmacies.

Ready to Get Started? Arizona Men Can See a Provider This Week.

TRAVERSE changed the conversation. Now it's your turn to start one of your own.

Men in Gilbert, Queen Creek, and across Arizona have access to telehealth testosterone care built on current evidence — not caution borrowed from a 1941 case report. No waiting rooms. No unanswered questions. No provider who last reviewed TRT research in medical school.

The evidence is on your side. The question is whether you're going to act on it.

Labs, consult, optimization — that easy.

It all starts at steelcity-trt.com.

Frequently Asked Questions

Q: What did the TRAVERSE trial find about testosterone therapy and prostate cancer? A: The 2023 TRAVERSE trial enrolled 5,246 men with cardiovascular disease or high CVD risk and tracked them across 14,304 person-years of follow-up. It found no statistically significant difference in prostate cancer incidence between men using testosterone replacement therapy and those using placebo. The American Urological Association now holds a Grade B recommendation stating no evidence links TRT to prostate cancer development.

Q: Is TRT safe for men concerned about prostate cancer risk? A: For appropriately screened men, current evidence — including the TRAVERSE trial and the AUA's guidelines — indicates that TRT does not increase prostate cancer risk. It's important to note that TRAVERSE excluded men with PSA above 3.0 ng/mL or significant urinary symptoms (IPSS above 19), so these findings apply to men who meet standard screening criteria, not all men universally. Candidacy should be determined with a licensed provider.

Q: How does TRT affect PSA levels? A: According to the Saturation Model, men with low testosterone who begin TRT may experience a modest PSA increase as their androgen receptors shift from sub-saturated to saturated states. The 2023 TRAVERSE trial confirmed this response — and confirmed it did not translate into clinical malignancy. Steel City HRT & Weight Loss monitors PSA at every lab interval to track this pattern and catch any meaningful change early.

Q: What is the Low T Paradox and why does it matter? A: The Low T Paradox refers to growing evidence that chronically low testosterone may increase the risk of more aggressive prostate cancer phenotypes. According to a study published in Oncology Letters, men with testosterone below 300 ng/dL had a 5.6-fold increased risk of high-grade prostate cancer and a 72.4-fold increased risk of metastatic disease at diagnosis versus men with normal levels — suggesting untreated testosterone deficiency carries its own oncological risk.

Q: Can I get TRT in Arizona without visiting a clinic? A: Yes. Steel City HRT & Weight Loss is a LegitScript-certified telehealth clinic licensed in Arizona. Lab evaluation, provider consultation, and ongoing monitoring are handled entirely through telehealth. Medication is compounded through 503a-licensed pharmacies and delivered to your door. Men in Gilbert, Queen Creek, and across the state can start without an in-person visit.

Q: Does the TRAVERSE trial mean all men can safely use TRT? A: The TRAVERSE trial provides strong reassurance for appropriately screened hypogonadal men. However, mean follow-up was 33 months — long-term data beyond ten years remains an open area of research, and the trial excluded men with elevated PSA or significant urinary symptoms. TRT candidacy should always be evaluated by a licensed provider who can weigh individual labs, history, and risk factors.

This content is for informational purposes only and does not constitute medical advice. Consult a licensed provider before beginning any hormone or weight loss therapy. Jeremiah Velasquez, FNP-BC, AGACNP-BC, is a licensed nurse practitioner. Steel City HRT & Weight Loss is a LegitScript-certified telehealth clinic.