Testosterone replacement therapy in men with prostate cancer after proton therapy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 208-208
Author(s):  
Curtis Bryant ◽  
Bradford S. Hoppe ◽  
Nancy P. Mendenhall ◽  
Randal H. Henderson ◽  
Romaine Charles Nichols ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Function ◽  
Replacement Therapy ◽  
Proton Therapy ◽  
Serum Testosterone ◽  
Biochemical Failure ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Previously Treated

208 Background: Testosterone replacement therapy (TRT) in patients previously treated for prostate cancer is controversial. We analyzed biochemical relapse and sexual function in patients treated for prostate cancer with proton therapy (PT) at our institution who were later treated with TRT for hypogonadism. Methods: We reviewed the medical records of 27 patients with biopsy-proven, localized prostate cancer treated with definitive proton therapy (PT) at our institution between 2006 and 2012. Each patient had hypogondal symptoms and low-serum testosterone and received testosterone replacement after PT. Biochemical failure was defined by the Phoenix definition. Sexual function was reported using patient-reported data from the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Rates of sexual potency were also reported. Results: Twenty-three patients were included in the present analysis. The median follow-up duration was 38 months after PT and 14 months after initiation of TRT. After one to six months on TRT, the median serum testosterone level in this patient cohort increased from 238 to 497. No patient experienced a biochemical failure. The median prostate-specific antigen (PSA) did not significantly rise during the follow-up period. EPIC sexual summary, sexual function, and sexual bother scores all increased after initiation of TRT. The median sexual bother scores increased from 43.8 before TRT to 59.4 after 7 or more months of TRT. The median sexual summary scores improved from 50 to 61.8 and the median sexual function scores improved from 41.7 to 53 over the same time. Sexual potency also increased after TRT initiation from 50% to 68%, 7 or more months after TRT. Conclusions: For patients diagnosed with hypogonadism who were previously treated for prostate cancer, cautious use of testosterone replacement therapy does not appear to increase the risk of biochemical failure or increase PSA. Sexual function may improve to approximate pre-radiation levels in some cases. A prospective trial with long-term follow up is required to better support our findings.

scholarly journals Evolution of Guidelines for Testosterone Replacement Therapy

2019 ◽  
Vol 8 (3) ◽  
pp. 410 ◽  
Author(s):  
Hyun Park ◽  
Sun Ahn ◽  
Du Moon
Keyword(s):  
Clinical Practice ◽  
Replacement Therapy ◽  
Clinical Symptoms ◽  
Serum Testosterone ◽  
Diagnosis And Treatment ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Testosterone Deficiency ◽  
Developmental Growth

Testosterone is an essential hormone required for the developmental growth and maintenance of the male phenotype during the whole life. With the increasing male life expectancy worldwide and development of adequate testosterone preparations, the prescription of testosterone has increased tremendously. Testosterone replacement should be based on low serum testosterone and related clinical symptoms. In the last two decades, with the accumulation of data, official recommendations have evolved in terms of definition, diagnosis, treatment, and follow-up. In practice, it is better for physicians to follow the Institutional Official Recommendations or Clinical Practice Guideline for an adequate diagnosis and treatment of testosterone deficiency. Currently, four official recommendations are available for diagnosis and treatment of patients with testosterone deficiency. The inconsistencies in the guidelines merely create confusion among the physicians instead of providing clear information. Furthermore, there is no definite method to assess serum testosterone and clinical symptoms. In the era of active testosterone replacement therapy (TRT), physicians’ practice patterns should be consistent with the clinical practice guidelines to avoid the misuse of testosterone. In this review, the author introduces the evolution of clinical guidelines to provide a comprehensive understanding of the differences and controversies with respect to TRT.

scholarly journals Testosterone Replacement Therapy in Men with Prostate Cancer after Proton Therapy

2014 ◽  
Vol 1 (3) ◽  
pp. 682-691 ◽  
Author(s):  
Curtis Bryant ◽  
Bradford S. Hoppe ◽  
Nancy P. Mendenhall ◽  
Randal H. Henderson ◽  
R. Charles Nichols ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Replacement Therapy ◽  
Proton Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy

Testosterone Replacement Therapy in Men with Prostate Cancer after Proton Therapy

2014 ◽  
pp. 141211132049007
Author(s):  
Curtis Bryant ◽  
Bradford S. Hoppe ◽  
Nancy P. Mendenhall ◽  
Randal H. Henderson ◽  
R. Charles Nichols ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Replacement Therapy ◽  
Proton Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy

scholarly journals Testosterone Replacement Therapy and the Risk of Prostate Cancer in Men With Late-Onset Hypogonadism

2019 ◽  
Vol 188 (9) ◽  
pp. 1666-1673 ◽  
Author(s):  
Christina Santella ◽  
Christel Renoux ◽  
Hui Yin ◽  
Oriana H Y Yu ◽  
Laurent Azoulay
Keyword(s):  
Prostate Cancer ◽  
Replacement Therapy ◽  
Late Onset ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Late Onset Hypogonadism ◽  
The Impact

Abstract The association between the use of testosterone replacement therapy (TRT) and prostate cancer remains uncertain. Thus, we investigated whether TRT is associated with an increased risk of prostate cancer in men with late-onset hypogonadism. We used the UK Clinical Practice Research Datalink to assemble a cohort of 12,779 men who were newly diagnosed with hypogonadism between January 1, 1995, and August 31, 2016, with follow-up until August 31, 2017. Exposure to TRT was treated as a time-varying variable and lagged by 1 year to account for cancer latency, with nonuse as the reference category. During 58,224 person-years of follow-up, a total of 215 patients were newly diagnosed with prostate cancer, generating an incidence rate of 3.7 per 1,000 person-years. In time-dependent Cox proportional hazards models, use of TRT was not associated with an overall increased risk of prostate cancer (hazard ratio = 0.97; 95% confidence interval: 0.71, 1.32) compared with nonuse. Results remained consistent in secondary and sensitivity analyses, as well as in a propensity score–matched cohort analysis that further assessed the impact of residual confounding. Overall, the use of TRT was not associated with an increased risk of prostate cancer in men with late-onset hypogonadism.

Testosterone replacement therapy and prostate cancer: A word of caution

2007 ◽  
Vol 8 (3) ◽  
pp. 185-189 ◽  
Author(s):  
Timothy C. Brand ◽  
Edith Canby-Hagino ◽  
Ian M. Thompson
Keyword(s):  
Prostate Cancer ◽  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy
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