Androgen replacement therapy in hypogonadal men undergone radical retropubic prostatectomy
https://doi.org/10.17650/1726-9776-2008-4-1-45-48
Abstract
Purpose: To assess the effectiveness and safety of testosterone replacement therapy (TRT) in a cohort of hypogonadal patients treated withradical retropubic prostatectomy (RRP) for localized prostate cancer.
Materials and Methods: the results of treatment of sixteen patients that underwent RRP for organ confined prostate cancer from 2001 to 2005 are analyzed. Before and after realization of TRT the content of the total testosterone in the blood serum, level of prostate specific antigen (PSA) in blood as well as intensity of the symptomatology according to the Aging Male Symptoms (AMS) Scale.
Results: At a mean duration of TRT for 15 months the TT raised from 6.5±1.98 nmol/l to 19.2±5.1 nmol/l (р < 0.01), the AMS score decreased from 40.4±5.4 to 20.8±3.8. No biochemical or clinical evidence of prostate cancer was found in any of the patients.
Conclusions: Based on the clinical experience with this group of 16 patients and the data of the literature, we conclude that highly selected hypogonadal patients surgically cured of prostate cancer can be treated with TRT safely with beneficial results, although to formulate the clinical guidelines on TRT use in patients surgically cured of prostate cancer, the large prospective multicenter studies with a big amount of patients are essential.
About the Authors
D. Y. PushkarRussian Federation
A. V. Govorov
Russian Federation
A. S. Segal
Russian Federation
References
1. Han M., Partin A.W., Zahurak M. et al. Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 2003;169:517—523.
2. Slater S., Oliver R.T. Testosterone: its role in development of prostate cancer and potential risk from use as hormone replacement therapy. Drugs Aging 2000;17:431—9.
3. McConnell J., Denis L., Akaza H. et al. Prostate cancer. Chapter 9. Androgen therapy in men at risk for prostate disease. 2006. p. 360—2.
4. Kaufman J.M., Graydon R.J. Androgen replacement after curative radical prostatectomy for prostate cancer in hypogonadal men. J Urol 2004;172:920—2.
5. Agarwal P.K., Oefelein M.G. Testosterone replacement therapy after primary treatment for prostate cancer. J Urol 2005;173:533—6.
6. Rhoden E.L., Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. N Engl J Med 2004;350:482—92.
7. Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol 2006;50:935—9.
8. Пушкарь Д.Ю., Сегал А.С. Андрогенозаместительная терапия и состояние предстательной железы. Фарматека 2006;15:62—5.
9. Tubaro A. Testosterone and prostate cancer. Eur Urol 2007;51:293—5.
10. Rhoden E., Morgentaler A. Testosterone replacement therapy in hypogonadal men at high risk of prostate cancer: results of 1 year treatment in men with prostatic intraepithelial neoplasia. J Urol 2003;170:2348—51.
11. Hoffman M.A., DeWolf W.C., Morgentaler A. Is low serum free testosterone a marker for high grade prostate cancer? J Urol 2000;163:824—7.
12. Massengill J.C., Sun L., Moul J.W. et al. Pretreatment total testosterone level predicts pathological stage in patients with localized prostate cancer treated with radical prostatectomy. J Urol 2003;169:1670—5.
Review
For citations:
Pushkar D.Y., Govorov A.V., Segal A.S. Androgen replacement therapy in hypogonadal men undergone radical retropubic prostatectomy. Cancer Urology. 2008;4(1):45-48. (In Russ.) https://doi.org/10.17650/1726-9776-2008-4-1-45-48