Testosterone levels and quality of life in diverse male patients with cancers unrelated to androgens.
OBJECTIVE
Symptoms secondary to hormonal changes significantly impact quality of life (QoL) in patients with cancer. This cross-sectional study examines prevalence of hypogonadism and its correlation with QoL and sexual dysfunction.


METHODS
We collected blood and medical histories from 428 male patients with non-testosterone-related cancer at three cancer centers. Serum was analyzed for total testosterone (TT), free testosterone (FT), bioavailable testosterone (BAT), and sex hormone binding globulin (SHBG). The Functional Assessment of Cancer Therapy-Prostate (FACT-P) QoL questionnaire measured physical, social, emotional, and functional domains as well as sexual function. Exclusion criteria were prostate, testicular, or male breast cancer; known hypogonadism; and HIV.


RESULTS
Mean and median TTs were 337.46 and 310 ng/dL, respectively. The mean age of patients was 62.05 years. The crude prevalence of hypogonadism (ie, TT < 300 ng/dL) was 48%, and mean TT in hypogonadal patients was 176 ng/dL. The prevalences that were based on FT (ie, hypogonadal < 52 pg/dL) and BAT (ie, hypogonadal < 95 ng/dL) were 78% and 66%, respectively. The mean FT and BAT values in hypogonadal patients were 25 pg/dL and 45 ng/dL, respectively. Hypogonadal patients had decreased total QoL scores on FACT-P (P = .01) and decreased three-item sexual function subset (P = .003).


CONCLUSIONS
The prevalence of hypogonadism was unexpectedly high. Measurement of FT or BAT detected a higher prevalence than TT alone, which confirmed previous studies. Correlation of T with FACT-P showed significant reduction of both overall QoL and sexual function for hypogonadal men. BAT and FT levels showed a stronger correlation than TT with overall FACT-P and subscales. The prevalence of symptomatic hypogonadism in male patients with cancer exceeds that found in comparable studies in noncancer populations.
Continuum Cancer Centers of New York, Beth Israel Medical Center and St Luke's-Roosevelt Hospital, New York, NY, USA.
Stewart B
SB
Fleishman
Hina
H
Khan
Peter
P
Homel
Mohammad F
MF
Suhail
Rotraud
R
Strebel-Amrhein
Farhan
F
Mohammad
Divya
D
Mahajan
Victoria
V
Rosenwald
Michael J
MJ
Guarino
Tahir
T
Mirzoyev
Timothy F
TF
Wozniak
Kathiresan
K
Suppiah
D000368:Aged; D002853:Chromatography, Liquid; D003430:Cross-Sectional Studies; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D049449:Luminescence; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000150:complications* / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D013739:Testosterone / Q000097:blood*
D013739:Testosterone