TESTOSTERONE REPLACEMENT THERAPY AFTER PROSTATE CANCER: THE EMERGENCE OF A NEW CONCEPT IN CURRENT UROLOGIC PRACTICE
Authors:
R. M. Coward; C. Culley; III. C. Carson
Authors‘ workplace:
Chapel Hill, NC 27599-7235, USA
; Physicians Office Bldg
Published in:
Urol List 2010; 8(4): 32-34
Overview
Previously considered to be completely unsafe, the topic of testosterone replacement therapy after prostate cancer treatment has recently received increasing attention as a viable treatment for testosterone deficiency syndrome diagnosed after successful treatment for prostate cancer. There are now several case series in the literature of men treated with prostatectomy, brachytherapy, and external beam radiation that have been safely treated with testosterone replacement, and the paradigm is shifting as our knowledge of androgen physiology grows. The current understanding of testosterone physiology indicates that prostate cancer does not have an increased growth rate with testosterone levels in the normal physiologic range. A recently reevaluated Saturation Model of androgen to androgen receptor binding sites explains how the change in prostate cancer growth rate only occurs at or below the castrate level of serum testosterone. There is also new evidence that, compared with higher testosterone levels, hypogonadism is of more significant concern secondary to its association with worrisome features of prostate cancer. No randomized controlled trials are available to date, although the latest available data support testosterone replacement after prostate cancer treatment as a safe treatment, with minimal to no risk of prostate cancer recurrence or progression.
KEY WORDS:
testosterone replacement therapy - hypogonadism - prostate cancer
Sources
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Paediatric urologist UrologyArticle was published in
Urological Journal
2010 Issue 4
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