Testosterone replacement therapy in men with low serum T and untreated prostate cancer


An article in the May issue of BJU International has proposed establishment of an international data registry as being “the quickest way” to establish basic data on the risks related to testosterone replacement therapy in men with untreated prostate cancer.

The risks associated with the use of testosterone replacement in men who have been treated for or who have untreated prostate cancer continue to be a matter of controversy. This new article by Morales would appear to be a sensible suggestion in seeking to resolve some of the critical questions, most especially in the case of men with untreated disease.

At the American Urological Association annual meeting just last week, it was Morales who argued during one session that there are still insufficient data to conclude that testosterone replacement therapy can be used with confidence in the treatment of men with low serum T levels who had already been treated for prostate cancer — although he conceded that data were increasingly suggesting that such therapy could be used with appropriate caution.

In the current article, Morales further argues that there are only two small series — comprising less than 25 men — in which supplemental testosterone has been used to treat men with low serum T levels and untreated prostate cancer. The basic evidence presented by Morales  suggests, in his opinion, that — in men with untreated prostate cancer — “responses to testosterone supplementation were varied … and were unpredictable.”

The “New” Prostate Cancer InfoLink concurs with Morales that the fastest and simplest way in which to resolve questions about the safety of testosterone supplementation is to do so through the use of a relatively simple registry with consistent data entry requirements, encompassing men with a history of prostate cancer (whether treated or not). Not only would such a database facilitate standard assessment of the degree of risk associated with testosterone supplements in prostate cancer patents, it might also allow us to identify clinical and/or biological characteristics among prostate cancer patients who could and who could not take testosterone supplements with safety.

Of course getting someone to pay for development of this database and persuading doctors to enroll their patients in such a registry would be two other factors that could be problematic to address.

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