Androgen replacement in men undergoing treatment for prostate cancer.
BACKGROUND
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.


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


METHODS
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.
Rhoden
Ernani Luis
EL
Division of Urology, Department of Surgery, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. ernanirh@yahoo.com.br
Averbeck
Márcio Augusto
MA
Teloken
Patrick E
PE
D000075202:Contraindications; D018450:Disease Progression; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy* / Q000209:etiology; D008134:Long-Term Care; D008297:Male; D011467:Prostate / Q000187:drug effects; D011471:Prostatic Neoplasms / Q000628:therapy*; D012307:Risk Factors; D013739:Testosterone / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D013739:Testosterone