Testosterone Administration To Men With Testosterone Deficiency Syndrome After External Beam Radiotherapy For Localized Prostate Cancer

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 05 Sep 2008 - 1:00 PDT

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UroToday.com - Dr. Alvaro Morales and associates from the Centre for Applied Urological Research, reported on the first study on testosterone deficiency syndrome (TDS) in men treated with radiotherapy for prostate cancer. Five men with clinically localized CaP were prospectively studied. The mean Gleason sum was 7 and mean PSA level before radiotherapy was 12.8ng/ml. The mean PSA before testosterone replacement therapy (TRT) was 0.3ng/ml.

All five men had symptoms of TDS and two chose intramuscular injections of testosterone, one oral replacement and two used transdermal patches. Testosterone levels before TRT were 5.3 and at last visit were 17.6. The duration of follow-up was 14.6 months. One man had a transitory PSA increase, but none had levels of >1.5ng/ml.

All patients had marked responses in the symptoms of TDS, four with decreased hot flashes, decreased fatigue and improved libido, and two reported improved erectile function. One man discontinued therapy due to headaches. Four men had an improvement in sexual interest, but none recovered satisfactory erectile function with testosterone alone. A phosphodiesterase-5 inhibitor was successful in three men. The best overall symptom improvements were in hot flashes and fatigue. This report is hypothesis-generating for larger studies to address this issue.

Morales A, Black AM, Emerson LE
BJU Int. 2008 Jul 29. Epub ahead of print.
doi:10.1111/j.1464-410X.2008.07882.x

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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