INTRODUCTION: Limited literature regarding the safety of testosterone (T) therapy (TTh) in men treated for prostate cancer (CaP) exists. Here we present multiinstitutional data for TTh in hypogonadal men with CaP treated with radiation therapy (RT).
METHODS: A retrospective review of hypogonadal men treated with TTh after RT for CaP at four institutions was performed. Serum testosterone, free T (FT), estradiol (E), sex hormone-binding globulin (SHBG), prostate specific antigen (PSA), PSA velocity, and prostate biopsy findings were analyzed.
RESULTS: There were 98 men treated with RT, with median age 70.0 years (range 63.0-74.3) at initiation of TTh. Baseline T levels were 209 (152-263) ng/dL and PSA 0.08 (0.00-0.33) ng/mL. The cohort comprised 3 (3.1%) men with Gleason score (Gl) 5, 44 (44.9%) men with Gl 6, 28 (28.6%) with Gl 7, 7 (7.1%) with Gl 8, and 4 (4.1%) with Gl 9 tumors. Median duration of follow-up was 40.8 months (range 1.5-147). Serum T increased to 420 ng/dl (231-711) (p< 0.001) during follow-up. Overall, a non-significant increase in mean PSA from 0.08 ng/mL at baseline to 0.09 ng/mL (p=0.05) was observed. Among high-risk patients, PSA increased from 0.10 ng/mL to 0.36 ng/mL (p=0.018). Six (6.1%) men met criteria for biochemical recurrence (BCR).
CONCLUSIONS: TTh in men following radiation therapy for CaP was associated with a minor increase in serum PSA and a low rate of BCR.
Pastuszak AW, Khanna A, Badhiwala N, Morgentaler A, Hult M, Conners WP, Sarosdy MF, Yang C, Carrion R, Lipshultz LI, Khera M. Are you the author?
Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX; Department of Urology, Washington University in St. Louis, St. Louis, IL; Harvard Medical School, Boston, MA; South Texas Urology and Urologic Oncology, San Antonio, TX; Department of Urology, University of South Florida Morsani College of Medicine, Tampa, FL.
Reference: J Urol. 2015 May 26. pii: S0022-5347(15)04081-1.