To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of CaP in this specific subset of patients. In addition, this manuscript aims to present a recent case report of a transgender woman with a unique presentation at the author's institution.
An electronic non-systematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer", "male to female transsexual", "transgender patient", "androgen+prostate cancer", "estrogen therapy+prostate cancer", "health care barrier". In addition, a clinical case managed at our Institution was reviewed and critically discussed.
Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a non-transgender male. Barriers to care in the transgender female population include: accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs. pathologizing trans patients, financial restrictions of the patient, and health system determinants.
While rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development is unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients.
Urology. 2017 Sep 04 [Epub ahead of print]
Nicholas A Deebel, Jacqueline P Morin, Riccardo Autorino, Randy Vince, Baruch Grob, Lance J Hampton
Division of Urology, Virginia Commonwealth University, Richmond, VA, USA., Division of Urology, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: .