J Kaufman
Int J Impot Res. 2006;18(1):26-31. ©2006 Nature Publishing Group
Abstract
With earlier detection and improved survival from early stage prostate cancer, it is likely that the numbers of men presenting with hypogonadal symptoms following curative surgery for their cancer will increase. Although testosterone supplementation is effective in improving symptoms of hypogonadism, traditionally such therapy has been contraindicated in patients who have had prostate cancer. This paper reviews the evidence that testosterone therapy can be safely given to selected men with hypogonadism who have had prostate cancer but currently have no evidence of disease by clinical and prostate-specific antigen (PSA) criteria. Such patients should be treated cautiously and followed closely.Table 2. Recommendations for Testosterone Replacement Therapy After Curative Treatment for Prostate Cancer
- Restrict to symptomatic hypogonadal men with
- favorable pretreatment disease and pathologic staging
- undetectable PSA (or <>
- Discuss pros and cons with patient and get informed consent
- Testosterone replacement therapy should be delayed after curative treatment for prostate cancer until undetectable PSA levels are confirmed
- Testosterone levels under treatment should be in the low normal range
- Monitoring should be performed every 3-6 months for the first year, then yearly thereafter, including the following procedures
- PSA
- Digital rectal exam
- Serum testosterone
