title: Recurrence of prostate cancer in patients receiving testosterone supplementation for hypogonadism.
abstract: OBJECTIVE
  The relationship between recurrent prostate cancer risk and testosterone replacement therapy (TRT) for hypogonadal men is explored.
  
  
  CONCLUSIONS
  The medical literature was searched to identify articles evaluating the use of TRT in symptomatic hypogonadal men with a history of prostate cancer. Eight English-language articles investigating TRT use in hypogonadal men with a history of prostate cancer were analyzed. For evaluative purposes, the normal ranges used for prostate-specific antigen (PSA) and total testosterone levels were less than 4.0 ng/mL and 300-1000 ng/dL, respectively. Most trials were small and involved patients with localized prostate cancer treated with radical prostatectomy or radiotherapy, though patients with metastatic disease or a Gleason score of ≥8 were included in a few studies. TRT was administered in a variety of dosages and dosage forms for up to nine years to manage hypogonadal symptoms. Testosterone concentrations increased, as expected, after TRT, but serum PSA levels remained below 0.1 ng/mL in the majority of patients. PSA levels were found to increase in select patients with high-risk and metastatic disease, but these elevations were not accompanied by disease progression. These studies have suggested a potential benefit for TRT use in select symptomatic hypogonadal men with a history of prostate cancer. Data were limited, however, by the retrospective nature of most studies, the lack of control groups, small sample sizes, and short follow-up periods.
  
  
  CONCLUSIONS
  There is insufficient evidence to withhold TRT in certain populations of men with a history of prostate cancer.
authors: Hayley Gray, Pharm.D., is Remote Prescription Approval System Pharmacist, Hunter Pharmacy Services, Austin, TX. Jennifer Seltzer, Pharm.D., is Clinical Assistant Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio. Robert L. Talbert, Pharm.D., BCPS, is Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio.
authors: Hayley
authors: H
authors: Gray
authors: Hayley Gray, Pharm.D., is Remote Prescription Approval System Pharmacist, Hunter Pharmacy Services, Austin, TX. Jennifer Seltzer, Pharm.D., is Clinical Assistant Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio. Robert L. Talbert, Pharm.D., BCPS, is Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio. seltzer@uthscsa.edu.
authors: Jennifer
authors: J
authors: Seltzer
authors: Hayley Gray, Pharm.D., is Remote Prescription Approval System Pharmacist, Hunter Pharmacy Services, Austin, TX. Jennifer Seltzer, Pharm.D., is Clinical Assistant Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio. Robert L. Talbert, Pharm.D., BCPS, is Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, San Antonio.
authors: Robert L
authors: RL
authors: Talbert
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced*; D011471:Prostatic Neoplasms / Q000139:chemically induced*; D013739:Testosterone / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D013739:Testosterone