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Published in: Current Urology Reports 3/2011

01-06-2011

Use of Testosterone Replacement Therapy in Patients with Prostate Cancer

Authors: Tanya B. Dorff, Nicholas J. Vogelzang

Published in: Current Urology Reports | Issue 3/2011

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Abstract

Prostate cancer is among the more common and less lethal malignancies, yielding a large population of survivors. The incidence of hypogonadism increases in the same elderly population of men who most frequently develop prostate cancer, and the risk of becoming hypogonadal is increased further by prostate cancer therapy. The relative safety of replacing testosterone to reduce symptoms of hypogonadism in men who have been treated for prostate cancer is not well established. We review the available data, provide suggestions for approaching the management of prostate cancer survivors who suffer hypogonadal symptoms, and describe other diagnostic and therapeutic uses of testosterone that have been employed in patients with prostate cancer.
Literature
1.
go back to reference Kamanagar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.CrossRef Kamanagar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.CrossRef
2.
go back to reference Harman SM, Metter E, Tobin EJ, et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001;86:724.PubMedCrossRef Harman SM, Metter E, Tobin EJ, et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001;86:724.PubMedCrossRef
3.
go back to reference Nejat RJ, Rashid HH, Bagiella E, et al. A prospective analysis of time to normalization of serum testosterone after withdrawal of androgen deprivation therapy. J Urol. 2000;164:1891–4.PubMedCrossRef Nejat RJ, Rashid HH, Bagiella E, et al. A prospective analysis of time to normalization of serum testosterone after withdrawal of androgen deprivation therapy. J Urol. 2000;164:1891–4.PubMedCrossRef
4.
go back to reference Pickles T, Agranovich A, Berthelet E, et al. Testosterone recovery following prolonged adjuvant androgen ablation for prostate carcinoma. Cancer. 2002;94:362–7.PubMedCrossRef Pickles T, Agranovich A, Berthelet E, et al. Testosterone recovery following prolonged adjuvant androgen ablation for prostate carcinoma. Cancer. 2002;94:362–7.PubMedCrossRef
5.
go back to reference Smith MR, Finkelstein JS, McGovern FJ, et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002;87:599–603.PubMedCrossRef Smith MR, Finkelstein JS, McGovern FJ, et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002;87:599–603.PubMedCrossRef
6.
go back to reference Keating NL, O’Malley J, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24:4448–53.PubMedCrossRef Keating NL, O’Malley J, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24:4448–53.PubMedCrossRef
7.
go back to reference Dhindsa S, Prabhakar S, Sethi M, et al. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab. 2004;89:5462–8.PubMedCrossRef Dhindsa S, Prabhakar S, Sethi M, et al. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab. 2004;89:5462–8.PubMedCrossRef
8.
go back to reference Saigal CS, Gore JL, Krupski TL, et al. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer. 2007;110:1493–500.PubMedCrossRef Saigal CS, Gore JL, Krupski TL, et al. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer. 2007;110:1493–500.PubMedCrossRef
9.
go back to reference Bhasin S, Storer TW, Berman N, et al. Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. J Clin Endocrinol Metab. 1997;82:407–13.PubMedCrossRef Bhasin S, Storer TW, Berman N, et al. Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. J Clin Endocrinol Metab. 1997;82:407–13.PubMedCrossRef
10.
go back to reference Wang C, Swerdloff RS, Iranmanesh A, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. J Clin Endocrinol Metab. 2000;85:2839–53.PubMedCrossRef Wang C, Swerdloff RS, Iranmanesh A, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. J Clin Endocrinol Metab. 2000;85:2839–53.PubMedCrossRef
11.
go back to reference Kapoor D, Goodwin E, Channer KS, Jones TH. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol. 2006;154:899–906.PubMedCrossRef Kapoor D, Goodwin E, Channer KS, Jones TH. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol. 2006;154:899–906.PubMedCrossRef
12.
go back to reference Smith MR, Malkowicz SB, Chu F, et al. Toremifene increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase 3 clinical study. J Urol. 2008;179:152–5.PubMedCrossRef Smith MR, Malkowicz SB, Chu F, et al. Toremifene increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase 3 clinical study. J Urol. 2008;179:152–5.PubMedCrossRef
13.
go back to reference Smith MR, Malkowicz SB, Chu F, et al. Toremifene improves lipid profiles in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase III study. J Clin Oncol. 2008;26:1824–9.PubMedCrossRef Smith MR, Malkowicz SB, Chu F, et al. Toremifene improves lipid profiles in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase III study. J Clin Oncol. 2008;26:1824–9.PubMedCrossRef
14.
go back to reference Huggins CB, Stevens RB, Hodges CV. The effects of castration on advanced carcinoma of the prostate gland. Arch Surg. 1941;43:209. Huggins CB, Stevens RB, Hodges CV. The effects of castration on advanced carcinoma of the prostate gland. Arch Surg. 1941;43:209.
15.
go back to reference Soto AM, Sonnenschein C. The two faces of Janus: sex steroids as mediators of both cell proliferation and cell death. J Natl Cancer Inst. 2001;93:1673.PubMedCrossRef Soto AM, Sonnenschein C. The two faces of Janus: sex steroids as mediators of both cell proliferation and cell death. J Natl Cancer Inst. 2001;93:1673.PubMedCrossRef
16.
go back to reference Wang YZ, Wong YC. Sex hormone-induced prostatic carcinogenesis in the noble rat: the role of insulin-like growth factor-I (IGF-1) and vascular endothelial growth factor (VEGF) in the development of prostate cancer. Prostate. 1998;35:165–77.PubMedCrossRef Wang YZ, Wong YC. Sex hormone-induced prostatic carcinogenesis in the noble rat: the role of insulin-like growth factor-I (IGF-1) and vascular endothelial growth factor (VEGF) in the development of prostate cancer. Prostate. 1998;35:165–77.PubMedCrossRef
17.
go back to reference Curran MJ, Bihrle W. Dramatic rise in prostate-specific antigen after androgen replacement in a hypogonadal man with occult adenocarcinoma of the prostate. Urology. 1999;53:423–4.PubMedCrossRef Curran MJ, Bihrle W. Dramatic rise in prostate-specific antigen after androgen replacement in a hypogonadal man with occult adenocarcinoma of the prostate. Urology. 1999;53:423–4.PubMedCrossRef
18.
go back to reference Loughlin KR, Richie JP. Prostate cancer after exogenous testosterone treatment for impotence. J Urol. 1997;157:1845.PubMedCrossRef Loughlin KR, Richie JP. Prostate cancer after exogenous testosterone treatment for impotence. J Urol. 1997;157:1845.PubMedCrossRef
19.
go back to reference Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. New Engl J Med. 2004;350:482–92.PubMedCrossRef Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. New Engl J Med. 2004;350:482–92.PubMedCrossRef
20.
go back to reference Rhoden EL, Morgentaler A. Testosterone replacement therapy in hypogonadal men at high risk for prostate cancer: results of 1 year of treatment in men with prostatic intraepithelial neoplasia. J Urol. 2003;170:2348–51.PubMedCrossRef Rhoden EL, Morgentaler A. Testosterone replacement therapy in hypogonadal men at high risk for prostate cancer: results of 1 year of treatment in men with prostatic intraepithelial neoplasia. J Urol. 2003;170:2348–51.PubMedCrossRef
21.
go back to reference Marks LS, Mazer NA, Mostaghel E, et al. Effect of testosterone replacement therapy on prostate tissue in men with late-onset hypogonadism. JAMA. 2006;296:2351–61.PubMedCrossRef Marks LS, Mazer NA, Mostaghel E, et al. Effect of testosterone replacement therapy on prostate tissue in men with late-onset hypogonadism. JAMA. 2006;296:2351–61.PubMedCrossRef
22.
go back to reference Sohlberg O, Brawer MK, Matsumoto A, Lange PH. Androgen provocative Testing (APT) after radical prostatectomy. J Urol 1990; 143: abstr 507. Sohlberg O, Brawer MK, Matsumoto A, Lange PH. Androgen provocative Testing (APT) after radical prostatectomy. J Urol 1990; 143: abstr 507.
23.
go back to reference • Sarosdy MF. Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy. Cancer. 2007;109:536–41. This series reports on outcomes for a homogeneous population of men treated with TRT after brachytherapy. PubMedCrossRef • Sarosdy MF. Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy. Cancer. 2007;109:536–41. This series reports on outcomes for a homogeneous population of men treated with TRT after brachytherapy. PubMedCrossRef
24.
go back to reference Morales A, Black AM, Emerson LE. Testosterone administration to men with testosterone deficiency syndrome after external beam radiotherapy for localized prostate cancer: preliminary observations. BJU Int. 2009;103:62–4.PubMedCrossRef Morales A, Black AM, Emerson LE. Testosterone administration to men with testosterone deficiency syndrome after external beam radiotherapy for localized prostate cancer: preliminary observations. BJU Int. 2009;103:62–4.PubMedCrossRef
25.
go back to reference Gerstenbluth RE, Maniam PN, Corty EW, Seftel AD. Prostate-specific antigen changes in hypogonadal men treated with testosterone replacement. J Androl. 2002;23:922–6.PubMed Gerstenbluth RE, Maniam PN, Corty EW, Seftel AD. Prostate-specific antigen changes in hypogonadal men treated with testosterone replacement. J Androl. 2002;23:922–6.PubMed
26.
go back to reference Agarwal PK, Oefelein MG. Testosterone replacement therapy after primary treatment for prostate cancer. J Urol. 2005;173:533–6.PubMedCrossRef Agarwal PK, Oefelein MG. Testosterone replacement therapy after primary treatment for prostate cancer. J Urol. 2005;173:533–6.PubMedCrossRef
27.
go back to reference Kaufman JM, Graydon RJ. Androgen replacement after curative radical prostatectomy for prostate cancer in hypogonadal men. J Urol. 2004;172:920–2.PubMedCrossRef Kaufman JM, Graydon RJ. Androgen replacement after curative radical prostatectomy for prostate cancer in hypogonadal men. J Urol. 2004;172:920–2.PubMedCrossRef
28.
go back to reference Khera M, Grober ED, Najari B, et al. Testosterone replacement therapy following radical prostatectomy. J Sex Med. 2009;6:1165–70.PubMedCrossRef Khera M, Grober ED, Najari B, et al. Testosterone replacement therapy following radical prostatectomy. J Sex Med. 2009;6:1165–70.PubMedCrossRef
29.
go back to reference • Leibowitz R, Dorff TB, Tucker S, et al. Testosterone replacement in prostate cancer survivors with hypogonadal symptoms. BJU Int. 2010;105:1397–401. This series is heterogeneous, but provides some description of outcomes for men treated with TRT who have prostate in place and/or metastatic disease. PubMedCrossRef • Leibowitz R, Dorff TB, Tucker S, et al. Testosterone replacement in prostate cancer survivors with hypogonadal symptoms. BJU Int. 2010;105:1397–401. This series is heterogeneous, but provides some description of outcomes for men treated with TRT who have prostate in place and/or metastatic disease. PubMedCrossRef
30.
go back to reference Bruchovsky N, Goldenberg SL, Gleave M. Interittent hormonal therapy for prostate cancer in Adv Urology 1997, vol 10 in Mosby-Year Book. Bruchovsky N, Goldenberg SL, Gleave M. Interittent hormonal therapy for prostate cancer in Adv Urology 1997, vol 10 in Mosby-Year Book.
31.
go back to reference Sato N, Gleave ME, Bruchovsky N, et al. Intermittent androgen deprivation delays progression to androgen-independent regulation of prostate-specific antigen gene in the LNCaP prostate tumor model. J Steroid Biochem Mol Biol. 1996;58:139–46.PubMedCrossRef Sato N, Gleave ME, Bruchovsky N, et al. Intermittent androgen deprivation delays progression to androgen-independent regulation of prostate-specific antigen gene in the LNCaP prostate tumor model. J Steroid Biochem Mol Biol. 1996;58:139–46.PubMedCrossRef
32.
go back to reference Fowler JE, Whtimore WF. The response of metastatic adenocarcinoma of the prostate to exogenous testosterone. J Urol. 1981;126:372–5.PubMed Fowler JE, Whtimore WF. The response of metastatic adenocarcinoma of the prostate to exogenous testosterone. J Urol. 1981;126:372–5.PubMed
33.
go back to reference • Morris MJ, Huang D, Kelly WK, et al. Phase I trial of high-dose exogenous testosterone in patients with castration-resistant metastatic prostate. Eur Urol. 2009;56:237–44. This clinical trial escalated duration rather than dose of TRT and documented safety. PubMedCrossRef • Morris MJ, Huang D, Kelly WK, et al. Phase I trial of high-dose exogenous testosterone in patients with castration-resistant metastatic prostate. Eur Urol. 2009;56:237–44. This clinical trial escalated duration rather than dose of TRT and documented safety. PubMedCrossRef
34.
go back to reference • Szmulewitz R, Mohile S, Posadas E, et al. A randomized phase I study of testosterone replacement for patients with low-risk castration-resistant prostate cancer. Eur Urol. 2009;56:97–104. This trial escalated doses of TRT and documented safety, with some PSA declines. PubMedCrossRef • Szmulewitz R, Mohile S, Posadas E, et al. A randomized phase I study of testosterone replacement for patients with low-risk castration-resistant prostate cancer. Eur Urol. 2009;56:97–104. This trial escalated doses of TRT and documented safety, with some PSA declines. PubMedCrossRef
35.
go back to reference Rathkopf D, Carducci MA, Morris MJ, et al. Phase II trial of docetaxel with rapid androgen cycling for progressive noncastrate prostate cancer. J Clin Oncol. 2008;26:2959–65.PubMedCrossRef Rathkopf D, Carducci MA, Morris MJ, et al. Phase II trial of docetaxel with rapid androgen cycling for progressive noncastrate prostate cancer. J Clin Oncol. 2008;26:2959–65.PubMedCrossRef
36.
go back to reference Stephenson AJ, Scardino PT, Eastham JA, et al. Post-operative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol. 2005;23:7005–12.PubMedCrossRef Stephenson AJ, Scardino PT, Eastham JA, et al. Post-operative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol. 2005;23:7005–12.PubMedCrossRef
37.
go back to reference Geck P, Maffini MP, Szelei J, et al. Androgen-induced proliferative quiescence in prostate cancer: the role of AS3 as its mediator. Proc Natl Acad Sci. 2000;97:10185–90.PubMedCrossRef Geck P, Maffini MP, Szelei J, et al. Androgen-induced proliferative quiescence in prostate cancer: the role of AS3 as its mediator. Proc Natl Acad Sci. 2000;97:10185–90.PubMedCrossRef
38.
go back to reference Kahn SM, Li YH, Hryb DJ, et al. Sex hormone-binding globulin influences gene expression of LNCaP and MCF-7 cells in response to androgen and estrogen treatment. Adv Exp Med Biol. 2008;617:557–64.PubMedCrossRef Kahn SM, Li YH, Hryb DJ, et al. Sex hormone-binding globulin influences gene expression of LNCaP and MCF-7 cells in response to androgen and estrogen treatment. Adv Exp Med Biol. 2008;617:557–64.PubMedCrossRef
39.
go back to reference Sonnenschein C, Olea N, Pasanen ME, Soto AM. Negative controls of cell proliferation: human prostate cancer cells and androgens. Cancer Res. 1989;49:3474–81.PubMed Sonnenschein C, Olea N, Pasanen ME, Soto AM. Negative controls of cell proliferation: human prostate cancer cells and androgens. Cancer Res. 1989;49:3474–81.PubMed
40.
go back to reference Attard G, Reid AHM, A’Hern R, et al. Selective inhibition of cyp17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol. 2009;27:3742–8.PubMedCrossRef Attard G, Reid AHM, A’Hern R, et al. Selective inhibition of cyp17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol. 2009;27:3742–8.PubMedCrossRef
Metadata
Title
Use of Testosterone Replacement Therapy in Patients with Prostate Cancer
Authors
Tanya B. Dorff
Nicholas J. Vogelzang
Publication date
01-06-2011
Publisher
Current Science Inc.
Published in
Current Urology Reports / Issue 3/2011
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-011-0176-2

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