1489 TESTOSTERONE REPLACEMENT THERAPY AFTER RADIATION THERAPY FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy1 Apr 20121489 TESTOSTERONE REPLACEMENT THERAPY AFTER RADIATION THERAPY FOR PROSTATE CANCER Alexander W. Pastuszak, Amy M. Pearlman, Larry I. Lipshultz, and Mohit Khera Alexander W. PastuszakAlexander W. Pastuszak Houston, TX More articles by this author , Amy M. PearlmanAmy M. Pearlman Houston, TX More articles by this author , Larry I. LipshultzLarry I. Lipshultz Houston, TX More articles by this author , and Mohit KheraMohit Khera Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Controversy and a lack of consensus surround the administration of testosterone replacement therapy (TRT) in men with a history of prostate cancer (CaP), particularly in light of studies suggesting that TRT promotes its growth. We assessed the response to TRT in a cohort of men with a history of CaP treated with radiation therapy (XRT). METHODS A retrospective review of 10 men with hypogonadism treated with TRT after brachytherapy or external beam radiation for CaP at Baylor College of Medicine between 2008-2011 was performed. Serum testosterone (T), free testosterone (FT), and prostate specific antigen (PSA) values were assessed as a function of time. PSA velocities (PSAV) were calculated for each patient. Prostate biopsy pathology results and symptomatic improvement were also evaluated. RESULTS The mean±SD age at TRT initiation was 67±7.8 years (range 54-82 years) and mean±SD initial serum hormone levels were: T 207.70(87.09) ng/dL, FT 4.99(2.49) ng/dL, PSA 0.61(0.44) ng/ml. Prostate biopsies demonstrated 10% of men with Gleason (Gl) 6, 30% with Gl 7, and 10% with Gl 8 disease. Median follow-up was 17.8 months (range 0-23.7 months). At median follow-up, a statistically significant increase in T (mean 388.5±198.8 ng/dL, p=0.019) was observed, with no significant increase in FT (mean 8.16±4.84 ng/dL, p=0.127) or PSA (mean 0.98±0.74 ng/mL, p=0.253). The mean difference between baseline and median follow up PSA was -0.16 ng/mL. No significant increases in PSA were observed at any interval up to 23.7 months of follow up (p=0.783). Furthermore, mean PSAV within the cohort was -0.67 ng/mL/year. A single patient with a PSAV of 0.93 ng/ml/year had further workup, which was negative for CaP recurrence. In the remainder of the cohort, PSAV did not rise above 0.30 ng/ml/year at any point during follow up. In terms of symptomatic improvement, increased energy was observed in 50% of men, increased libido in 60%, and improved erections in 50%. CONCLUSIONS Our data demonstrate that TRT in the setting of CaP after treatment with XRT results in a rise in serum total testosterone levels and improvement in hypogonadal symptoms without evidence of CaP recurrence or progression. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e603 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander W. Pastuszak Houston, TX More articles by this author Amy M. Pearlman Houston, TX More articles by this author Larry I. Lipshultz Houston, TX More articles by this author Mohit Khera Houston, TX More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...