Testosterone administration to men with testosterone deficiency syndrome after external beam radiotherapy for localized prostate cancer: preliminary observations.
OBJECTIVE
To assess the effects of testosterone supplementation in men with testosterone deficiency syndrome (TDS) after external beam radiotherapy (EBRT) for localized prostate cancer.


METHODS
Five men with significant signs of TDS after treatment for localized prostate cancer with EBRT were treated with testosterone once their prostate-specific antigen (PSA) level had reached the nadir. RESULTS The mean (range) level of testosterone before supplementation was 5.2 (1.1-9.2) nmol/L and the duration of follow-up while on supplementation was 14.5 (6-27) months. At the last visit, the testosterone levels were 17.6 (8.5-32.4) nmol/L. One of the five patients had a transitory increase in PSA level but none had levels of >1.5 ng/mL. All patients reported a marked response in the manifestations of TDS, i.e. four each reported decreased hot flushes, decreased fatigue and improved libido, and two reported improved erectile function.


CONCLUSIONS
Men with TDS after EBRT for localised prostate cancer are candidates for testosterone therapy. The patients must be aware of the advantages and disadvantages of the treatment. PSA levels must have reached a nadir before starting treatment and the follow-up must be particularly close. In these few patients there were no adverse effects from testosterone supplementation. There is a need for more information about the safety and efficacy of testosterone therapy in men successfully treated for localized prostate cancer, because there is evidence indicating hypogonadism in these patients, compromising their quality of life and longevity, independent of the cancer.
Morales
Alvaro
A
Centre for Applied Urological Research, Queen's University, Kingston, Ontario, Canada. moralesa@post.queensu.ca
Black
Angela M
AM
Emerson
Laurel E
LE
D000368:Aged; D000728:Androgens / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy* / Q000209:etiology; D007989:Libido / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011788:Quality of Life; D013739:Testosterone / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use*; D016896:Treatment Outcome
D000728:Androgens; D013739:Testosterone; D017430:Prostate-Specific Antigen