title: Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy.
abstract: OBJECTIVE
  Testosterone replacement therapy in men with prostate cancer is controversial, with concern that testosterone can stimulate cancer growth. We evaluated the safety and efficacy of testosterone in hypogonadal men with prostate cancer treated with radical prostatectomy.
  
  
  METHODS
  We performed a review of 103 hypogonadal men with prostate cancer treated with testosterone after prostatectomy (treatment group) and 49 nonhypogonadal men with cancer treated with prostatectomy (reference group). There were 77 men with low/intermediate (nonhigh) risk cancer and 26 with high risk cancer included in the analysis. All men were treated with transdermal testosterone, and serum hormone, hemoglobin, hematocrit and prostate specific antigen were evaluated for more than 36 months.
  
  
  RESULTS
  Median (IQR) patient age in the treatment group was 61.0 years (55.0-67.0), and initial laboratory results included testosterone 261.0 ng/dl (213.0-302.0), prostate specific antigen 0.004 ng/ml (0.002-0.007), hemoglobin 14.7 gm/dl (13.3-15.5) and hematocrit 45.2% (40.4-46.1). Median followup was 27.5 months, at which time a significant increase in testosterone was observed in the treatment group. A significant increase in prostate specific antigen was observed in the high risk and nonhigh risk treatment groups with no increase in the reference group. Overall 4 and 8 cases of cancer recurrence were observed in treatment and reference groups, respectively.
  
  
  CONCLUSIONS
  Thus, testosterone therapy is effective and, while followed by an increase in prostate specific antigen, does not appear to increase cancer recurrence rates, even in men with high risk prostate cancer. However, given the retrospective nature of this and prior studies, testosterone therapy in men with history of prostate cancer should be performed with a vigorous surveillance protocol.
authors: Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors: Alexander W
authors: AW
authors: Pastuszak
authors: Amy M
authors: AM
authors: Pearlman
authors: Win Shun
authors: WS
authors: Lai
authors: Guilherme
authors: G
authors: Godoy
authors: Kumaran
authors: K
authors: Sathyamoorthy
authors: Joceline S
authors: JS
authors: Liu
authors: Brian J
authors: BJ
authors: Miles
authors: Larry I
authors: LI
authors: Lipshultz
authors: Mohit
authors: M
authors: Khera
mesh_terms: D000368:Aged; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D013739:Testosterone; D017430:Prostate-Specific Antigen
keywords: ADT; BCR; CaP; Hct; Hgb; PSA; PSA velocity; PSAV; RP; T; TRT; androgen deprivation therapy; biochemical recurrence; hematocrit; hemoglobin; hormone replacement therapy; hypogonadism; prostate cancer; prostate specific antigen; prostatectomy; prostatic neoplasms; radical prostatectomy; testosterone; testosterone replacement therapy
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