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Hypogonadism and Prostate Cancer: To Treat or Not to Treat

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Clinical Urologic Endocrinology

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Abstract

For decades, testosterone replacement therapy has been avoided in men with a history of prostate cancer due to concerns that testosterone may cause prostate cancer progression or recurrence. However, this concern is not well founded by the medical literature. Moreover, during the PSA era, there has been no significant data to show that testosterone causes prostate cancer progression or recurrence. In fact, there have been several studies suggesting that testosterone may be protective against prostate cancer. There are many theories, such as the prostate saturation theory, that may help us understand why testosterone may be safely administered in men with hypogonadism even after surgical treatment of prostate cancer. Because patients with hypogonadism may already be at a significant disadvantage in recovering their erectile function after prostatectomy, they perhaps should receive special consideration as candidates for androgen replacement therapy.

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Abbreviations

ADT:

Androgen deprivation therapy

DHT:

Dihydrotestosterone

FT:

Free testosterone

LHRH:

Luteinizing-hormone-releasing hormone

NO:

Nitric oxide

NOS:

Nitric oxide synthase

PDE5:

Phosphodiesterase type 5

PSA:

Prostate-specific antigen

RP:

Radical prostatectomy

SHBG:

Sex-hormone-binding globulin

TRT:

Testosterone replacement therapy

TT:

Total testosterone

XRT:

External beam radiation

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Author information

Authors and Affiliations

  1. Division of Male Reproductive Medicine and Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1320, Houston, TX, 77030, USA

    Mohit Khera M.D., M.B.A., M.P.H.

Authors
  1. Mohit Khera M.D., M.B.A., M.P.H.
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Corresponding author

Correspondence to Mohit Khera M.D., M.B.A., M.P.H. .

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Editors and Affiliations

  1. , Department of Urology, Austin Fertility & Reproductive Medicine, JAMES CASEY SUITE B 4303, AUSTIN, 78745, Texas, USA

    Parviz K. Kavoussi

  2. University of Virginia School of Medicin, University Of Virginia Hospital, 1300 Jefferson Parks Avenue, Charlottesville, 22903, Virginia, USA

    Raymond A. Costabile

  3. Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, Milan, 20132, Italy

    Andrea Salonia

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Khera, M. (2013). Hypogonadism and Prostate Cancer: To Treat or Not to Treat. In: Kavoussi, P., Costabile, R., Salonia, A. (eds) Clinical Urologic Endocrinology. Springer, London. https://doi.org/10.1007/978-1-4471-4405-2_6

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  • DOI: https://doi.org/10.1007/978-1-4471-4405-2_6

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