title: Testosterone Therapy after Radiation Therapy for Low, Intermediate and High Risk Prostate Cancer.
abstract: OBJECTIVE
  Limited literature exists regarding the safety of testosterone therapy in men treated for prostate cancer. We present multi-institutional data on testosterone therapy in hypogonadal men with prostate cancer treated with radiation therapy.
  
  
  METHODS
  We retrospectively reviewed the records of hypogonadal men treated with testosterone therapy after radiation therapy for prostate cancer at 4 institutions. Serum testosterone, free testosterone, estradiol, sex hormone-binding globulin, prostate specific antigen, prostate specific antigen velocity and prostate biopsy findings were analyzed.
  
  
  RESULTS
  A total of 98 men were treated with radiation therapy. Median age was 70.0 years (range 63.0 to 74.3) at initiation of testosterone therapy. Median baseline testosterone was 209 ng/dl (range 152 to 263) and median baseline prostate specific antigen was 0.08 ng/ml (range 0.00 to 0.33). In the cohort the tumor Gleason score was 5 in 3 men (3.1%), 6 in 44 (44.9%), 7 in 28 (28.6%), 8 in 7 (7.1%) and 9 in 4 (4.1%). Median followup was 40.8 months (range 1.5 to 147). Serum testosterone increased to a median of 420 ng/dl (range 231 to 711) during followup (p <0.001). Overall a nonsignificant increase in mean prostate specific antigen was observed from 0.08 ng/ml at baseline to 0.09 ng/ml (p = 0.05). Among patients at high risk prostate specific antigen increased from 0.10 to 0.36 ng/ml (p = 0.018). Six men (6.1%) met criteria for biochemical recurrence.
  
  
  CONCLUSIONS
  Testosterone therapy in men following radiation therapy for prostate cancer was associated with a minor increase in serum prostate specific antigen and a low rate of biochemical recurrence.
authors.affiliation: Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Pastuszak
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Khanna
authors.affiliation: Department of Urology, Washington University in St. Louis, St. Louis, Illinois.
authors.forename: Niraj
authors.initials: N
authors.lastname: Badhiwala
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Abraham
authors.initials: A
authors.lastname: Morgentaler
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Mariam
authors.initials: M
authors.lastname: Hult
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: William P
authors.initials: WP
authors.lastname: Conners
authors.affiliation: South Texas Urology and Urologic Oncology, San Antonio, Texas.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Sarosdy
authors.affiliation: Department of Urology, University of South Florida Morsani College of Medicine, Tampa, Florida.
authors.forename: Christopher
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Urology, University of South Florida Morsani College of Medicine, Tampa, Florida.
authors.forename: Rafael
authors.initials: R
authors.lastname: Carrion
authors.affiliation: Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Larry I
authors.initials: LI
authors.lastname: Lipshultz
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas. Electronic address: mkhera@bcm.edu.
authors.forename: Mohit
authors.initials: M
authors.lastname: Khera
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood / Q000627:therapeutic use*
chemical_list: D014408:Biomarkers, Tumor; D013739:Testosterone; D017430:Prostate-Specific Antigen
keywords: hormone replacement therapy; prostatectomy; prostatic neoplasms; radiotherapy; testosterone