664 TESTOSTERONE THERAPY IN MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized (III)1 Apr 2013664 TESTOSTERONE THERAPY IN MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER Mariam Hult and Abraham Morgentaler Mariam HultMariam Hult Brookline, MA More articles by this author and Abraham MorgentalerAbraham Morgentaler Brookline, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.219AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testosterone therapy (TTh) in men with prostate cancer (PCa) is controversial. Only one prior study, involving 13 men, has evaluated TTh in men on active surveillance for PCa. We here report our experience in a larger group of these men. METHODS A chart review was performed for all men in our practice who received TTh during active surveillance for PCa for a minimum of 6 months. Charts were assessed for patient age, pathology, prostate specific antigen (PSA), endocrine results, and cancer progression. Progression was defined by increased number of cores by 3 or more, or persistent increase in Gleason score of 1 or greater. RESULTS A total of 33 men received TTh while on active surveillance. Five received TTh for < 6 months and were excluded from further analysis. The remaining 28 patients had a mean age of 66.8 years (range 54 to 91) and received TTh for a mean of 36.2 + 22.6 months (range 7-81.6). Initial Gleason score was 6 in 26 men, and 7 (3+4) in 2 men. These men underwent an average of 1.1 follow-up biopsies. Testosterone therapy increased mean testosterone from 338 ng/dl at baseline to 594 ng/dl at 6 months (P < 0.0001). No significant increase in mean PSA was noted from baseline to last follow-up (2.8 ng/ml vs 3.0 ng/ml, respectively; P=0.41). No individual demonstrated definite clinical progression. A biopsy revealing an upgrade in Gleason score was noted in 7 men, all of whom had at least one subsequent biopsy revealing the original Gleason score, or no malignancy at all. Two men elected radical prostatectomy despite lack of clinical progression, and 2 discontinued TTh due to lack of efficacy. Of 28 evaluable men, 24 continue with TTh on active surveillance. CONCLUSIONS Testosterone therapy does not appear to cause PCa progression over the short-to-medium term in men with active surveillance. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e271 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariam Hult Brookline, MA More articles by this author Abraham Morgentaler Brookline, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...