Testosterone Therapy Does Not Raise Prostate Cancer Recurrence Risk

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Testosterone replacement therapy (TRT) does not appear to increase the risk of prostate cancer (PCa) recurrence in men following radical prostatectomy, researchers concluded.

Alexander W. Pastuszak, MD, PhD, of the Baylor College of Medicine in Houston, and colleagues reviewed data from 103 hypogonadal PCa patients treated with testosterone after radical prostatectomy (treatment group) and 49 PCa patients who underwent RP but were not hypogonadal (reference group). After a median follow-up of 27.5 months, researchers observed a significant increase in testosterone level in the treatment group, Dr. Pastuszak's group reported in the Journal of Urology (2013;190:639-644). The treatment group also experienced a significant rise in PSA level, whereas the reference group did not. Overall, biochemical recurrence (BCR) occurred a lower rate in the treatment group: four patients (3.8%) versus eight patients (16%). All recurrences in both groups were in patients with high-risk PCa.

Overall, 15% of the high-risk patients in the treatment group had BCR, which is lower than the 18% to 32% recurrence rate found in previous studies for patients not receiving TRT after radical prostatectomy during a comparable follow-up period.

To better understand whether the observed increase in PSA reflected PCa growth, the investigators calculated the PSA velocity (PSAV) for each group. The median PSAV for all patients in the treatment and reference groups was 0.002 and 0.0002 ng/mL per year, respectively, a nonsignificant difference between the groups.

Furthermore, the researchers found no significant difference in PSAV between the high-risk and non-high-risk subgroups in the treatment and reference groups, indicating that neither group had PSA increases at a rate suggestive of BCR, according to the researchers.

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