Shifting the Paradigm of Testosterone Replacement Therapy in Prostate Cancer

Michael A Bell; Jeffrey D Campbell; Gregory Joice; Nikolai A Sopko; Arthur L Burnett

doi:10.5534/wjmh.170007

Shifting the Paradigm of Testosterone Replacement Therapy in Prostate Cancer

World J Mens Health. 2018 May;36(2):103-109. doi: 10.5534/wjmh.170007. Epub 2018 Mar 22.

Authors

Michael A Bell¹, Jeffrey D Campbell², Gregory Joice¹, Nikolai A Sopko¹, Arthur L Burnett¹

Affiliations

¹ The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. jcampb84@jhmi.edu.

Abstract

Historically, testosterone and prostate cancer have been demonstrated to have a positive association leading providers to forgo testosterone replacement therapy (TRT) in men with concurrent histories of hypogonadism and prostate cancer. This paradigm has been gradually shifting with our evolving understanding of the relationship between testosterone and prostate cancer and the gaining popularity of the saturation model. Newer data suggests improved quality of life for men with hypogonadism after TRT leading to a more tempered view of the effects of this treatment and its risk in prostate cancer. As more reports emerge of TRT in men who have either undergone definitive treatment for prostate cancer or are on active surveillance, some providers see a role for TRT in these patients despite non-consensus in clinical guidelines. It is critical that we examine evidence currently available, while we await more rigorous data to emerge.

Keywords: Androgens; Hypogonadism; Prostate-specific antigen; Prostatic neoplasm; Testosterone.

Publication types

Review