title: Can testosterone therapy be offered to men on active surveillance for prostate cancer? Preliminary results.
abstract: This report presents our experience with T therapy in a cohort of T-deficient men on active surveillance (AS) for Gleason 3 + 3 and Gleason 3 + 4 prostate cancer (PCa). A retrospective chart review identified 28 men with T deficiency who underwent T therapy (T group) for at least 6 months while on AS for PCa. A comparison group of 96 men on AS for PCa with untreated T deficiency (no-T group) was identified at the same institution. The AS protocol followed a modified Epstein criteria and allowed inclusion of men with a single core of low-volume Gleason 3 + 4 PCa. Mean age was 59.5 and 61.3 years, and mean follow-up was 38.9 and 42.4 months for the T and no-T groups, respectively. Of all 28 men in the T group, 3 (10.7%) men developed an increase in Gleason score while on AS. Of 22 men in the T group with Gleason 3 + 3 disease, 7 (31.8%) men developed biopsy progression including 3 men (13.6%) who developed Gleason 3 + 4 PCa. Of 6 men with Gleason 3 + 4 disease at baseline, 2 (33.3%) men developed an increase in tumor volume, and none developed upgrading beyond Gleason 3 + 4. All 96 men in the no-T group had Gleason 3 + 3 disease at baseline and, 43 (44.7%) developed biopsy progression, including 9 men (9.38%) with upgrading to Gleason 7 (3 + 4). Biopsy progression rates were similar for both groups and historical controls. Biopsy progression in men on AS appears unaffected by T therapy over 3 years. Prospective placebo-controlled trials of T therapy in T-deficient men on AS should be considered given the symptomatic benefits experienced by treated men.
authors: Men's Health Boston, Brookline, MA, USA.
authors: Ravi
authors: R
authors: Kacker
authors: Mariam
authors: M
authors: Hult
authors: Ignacio F
authors: IF
authors: San Francisco
authors: William P
authors: WP
authors: Conners
authors: Pablo A
authors: PA
authors: Rojas
authors: William C
authors: WC
authors: Dewolf
authors: Abraham
authors: A
authors: Morgentaler
mesh_terms: D000368:Aged; D018450:Disease Progression; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D013739:Testosterone / Q000627:therapeutic use*; D057832:Watchful Waiting
chemical_list: D013739:Testosterone