Testosterone Replacement Safe for Men With Prostate Cancer
Findings emerge from a study of hypogonadal men who underwent radiation therapy, surgery, or active surveillance for prostate cancer.
Testosterone replacement therapy (TRT) does not worsen oncologic outcomes in hypogonadal men with prostate cancer, according to study findings presented at the Canadian Urological Association 2016 annual meeting in Vancouver.
Jesse Ory, of the University of British Columbia in Vancouver, and colleagues identified 83 hypogonadal men with prostate cancer (PCa) who received TRT. The group included 50 men who had radiation therapy (RT), 22 who underwent radical prostatectomy (RP), 8 placed on active surveillance (AS), 1 who had cryotherapy, and 1 treated with high-intensity focused ultrasound. The median patient age was 75.5 years and median follow-up was 41 months.
The investigators observed an increase in both testosterone and PSA levels in the entire cohort, but only patients with low-risk PCa had a statistically significant increase in PSA. PSA increased in the AS patients, but none of these patients were upgraded to a higher Gleason score on subsequent prostate biopsies and none have yet gone on to definitive treatment, the researchers reported. No RP patient experienced biochemical recurrence, but 3 RT patients (6%) did, as defined by 2006 Phoenix criteria (PSA nadir plus 2 ng/mL).
Dr. Ory's group said it is unclear whether these recurrences were related to TRT or reflected the natural biology of their disease.