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When and When Not To Use Testosterone for Palliation in Cancer Care

  • Palliative Medicine (A Jatoi, Section Editor)
  • Published:
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Abstract

Hypogonadism is common throughout the illness trajectory of patients with cancer. About two thirds of male patients with advanced cancer have hypothalamic–pituitary–gonadal dysfunction and low testosterone levels. Chronic inflammation, comorbidities, cachexia, chemotherapy, and medications such as opioids, megestrol acetate, and corticosteroids contribute to primary and secondary hypogonadism. Studies have reported increased symptom burden, diminished quality of life, and poor prognosis associated with low testosterone levels in males with cancer. The Endocrine Society has published clinical practice guidelines for replacing testosterone in symptomatic patients with chronic illness and in patients receiving opioids; however, the role of testosterone therapy specifically in patients with cancer is not addressed. This review explores the potential benefits and limitations of testosterone replacement on the basis of current evidence.

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Conflict of Interest

Rony Dev has received royalties from UpToDate.

Eduardo Bruera declares that he has no conflict of interest.

Egidio Del Fabbro has acted as a consultant for, received honoraria from, and had travel/accommodation expenses covered or reimbursed by Helsinn Therapeutics.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Rony Dev & Eduardo Bruera

  2. Division of Hematology/Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Egidio Del Fabbro

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  1. Rony Dev
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  2. Eduardo Bruera
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Correspondence to Egidio Del Fabbro.

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Dev, R., Bruera, E. & Del Fabbro, E. When and When Not To Use Testosterone for Palliation in Cancer Care. Curr Oncol Rep 16, 378 (2014). https://doi.org/10.1007/s11912-014-0378-0

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