Testosterone replacement in prostate cancer survivors with hypogonadal symptoms.

OBJECTIVE: To describe the clinical outcomes of prostate cancer survivors who were treated with high-dose testosterone-replacement therapy (TRT) for the relief of hypogonadal symptoms.

PATIENTS AND METHODS: We reviewed the records of 96 patients who received TRT after initial management for prostate cancer from 2000 to 2007.

RESULTS: In all, 41 men had prostate-specific antigen (PSA) progression (PSA Working Group) while on TRT, but only seven had radiographic progression of disease. Fifty-six men discontinued TRT due to increasing PSA levels, and 59% of these men had significant reductions in PSA level with no additional intervention. In all, 31 men remain on TRT with no PSA or radiological progression at a median of 36.7 months; nine men stopped TRT for reasons other than progression. Characteristics associated with continuing TRT were radical prostatectomy as primary management, a low PSA level when starting TRT, and concurrent use of dutasteride. Hypogonadal symptoms were alleviated in most cases.

CONCLUSIONS: While most men in this series had increasing PSA levels during TRT, stopping TRT typically resulted in PSA declines. A subset of men were able to remain on TRT for several years without disease progression.