ASCO 2017: Prostate cancer in 696 hypogonadal men with and without long-term testosterone therapy: Results from a … – UroToday

Posted: June 9, 2017 at 10:44 am

Chicago, IL (UroToday.com) The endocrinology relationship between testosterone and prostate cancer (PCa) is well-established, however whether men with hypogonadism have increased prostate cancer incidence or severity is controversial. Dr. Haider and colleagues from Germany presented their results of assessing prostate cancer outcomes among men on long-term testosterone therapy (TTh) at the 2017 ASCO annual meetings prostate cancer poster session.

A recent Canadian population-based observational study reported that men treated with testosterone replacement therapy were at decreased risk of prostate cancer diagnosis compared to controls [1]. Thus, the objective of this study was to assess the incidence and severity of prostate cancer in hypogonadal men on long-term testosterone therapy in comparison to an untreated hypogonadal control group.

For this study, 400 men with testosterone 350 ng/dL and symptoms received testosterone undecanoate 1000 mg replacement therapy every 3 months for up to 10 years, while 296 hypogonadal men (age 57-74) opted against replacement therapy and formed the control group. Prostate volume, PSA, weight and C-reactive protein (CRP) were assessed, and digital rectal examination/transrectal ultrasound was performed prior to testosterone therapy initiation and then every 6-12 months.

Over a median follow-up of 8 years and 5,000 patient-years, patients receiving testosterone replacement therapy had a statistically significant increase in prostate volume (2.4 mL, p

The authors concluded that hypogonadal men treated with testosterone therapy may have decreased incidence of prostate cancer compared to hypogonadal men not treated with testosterone. Given the inherent limitations of this study (a few, as such, mentioned above), this study certainly requires prospective validation. The implications of potentially feeling the need to treat all hypogonadal men with testosterone to perceivably decrease their risk of prostate cancer clearly has ramifications.

Presented By: Ahmad Haider, MD, PhD, Private Urology Practice, Bremerhaven, Germany

Co-Authors: Karim Sultan Haider

Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre Twitter: @zklaassen_md

at the 2017 ASCO Annual Meeting – June 2 – 6, 2017- Chicago, Illinois, USA

REFERENCES: 1. Wallis CJ, Lo K, Lee Y, et al. Survival and cardiovascular events in men treated with testosterone replacement therapy: an intention-to-treat observational cohort study. Lancet Diabetes Endocrinol 2016 Jun;4(6):498-506.

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ASCO 2017: Prostate cancer in 696 hypogonadal men with and without long-term testosterone therapy: Results from a … – UroToday

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