Testosterone replacement in prostate cancer survivors with hypogonadal symptoms.
OBJECTIVE
To describe the clinical outcomes of prostate cancer survivors who were treated with high-dose testosterone-replacement therapy (TRT) for the relief of hypogonadal symptoms.


METHODS
We reviewed the records of 96 patients who received TRT after initial management for prostate cancer from 2000 to 2007.


RESULTS
In all, 41 men had prostate-specific antigen (PSA) progression (PSA Working Group) while on TRT, but only seven had radiographic progression of disease. Fifty-six men discontinued TRT due to increasing PSA levels, and 59% of these men had significant reductions in PSA level with no additional intervention. In all, 31 men remain on TRT with no PSA or radiological progression at a median of 36.7 months; nine men stopped TRT for reasons other than progression. Characteristics associated with continuing TRT were radical prostatectomy as primary management, a low PSA level when starting TRT, and concurrent use of dutasteride. Hypogonadal symptoms were alleviated in most cases.


CONCLUSIONS
While most men in this series had increasing PSA levels during TRT, stopping TRT typically resulted in PSA declines. A subset of men were able to remain on TRT for several years without disease progression.
Leibowitz
Robert L
RL
Compassionate Oncology Medical Group, University of Southern California, Los Angeles CA, USA.
Dorff
Tanya B
TB
Tucker
Steven
S
Symanowski
James
J
Vogelzang
Nicholas J
NJ
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001378:Azasteroids / Q000627:therapeutic use; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D018120:Finasteride / Q000627:therapeutic use; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy*; D017741:Survivors; D013739:Testosterone / Q000627:therapeutic use*
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D001378:Azasteroids; D004791:Enzyme Inhibitors; D013739:Testosterone; D018120:Finasteride; D017430:Prostate-Specific Antigen; D000068538:Dutasteride