Androgen replacement in men undergoing treatment for prostate cancer.

INTRODUCTION

Hypogonadism is a clinical and biochemical syndrome that may cause significant detriment in the quality of life and adversely affect the function of multiple organ systems. With the increase in life expectancy and prostate cancer (PCa) survival, a significant increase in the number of men with hypogonadism who have undergone presumably curative treatment for PCa is anticipated.

AIM: To critically review the literature regarding testosterone replacement therapy (TRT) after PCa treatment with curative intent.

MAIN OUTCOME MEASURES: Review of peer-reviewed literature. There was special focus on the potential implications and safety of TRT in men with hypogonadism who have undergone curative treatment for PCa.

METHODS

English-language relevant publications were identified via electronic medical databases (MEDLINE, EMBASE, and DARE).

RESULTS

Despite the wide spread of contraindication of testosterone replacement in men with known or suspected PCa, there is no convincing evidence that the normalization of testosterone serum levels in men with low but no castrate levels is deleterious. In the few available case series describing testosterone replacement after treatment for PCa, no case of clinical or biochemical progression was observed.

CONCLUSIONS

Although further studies are necessary before definitive conclusions can be drawn, the available evidence suggests that TRT can be cautiously considered in selected hypogonadal men treated with curative intent for PCa and without evidence of active disease.