Testosterone replacement therapy isn't always contraindicated after prostate cancer treatment: case report
Rachel Smith, N Karavitaki & John Wass
We present the case of a 62 year old gentleman who was diagnosed with Acromegaly in 1998.
He commenced testosterone replacement therapy in the form of Sustanon every three weeks in October 2000 following a testosterone level of 6.6 nmol/l.
PSA levels during treatment with Sustanon were: 01/03/015.1μg/l.
06/04/014.9 μg/l at which point he was referred for a urological opinion.
On the 13/02/02 he underwent prostate biopsies which were benign.
Sustanon was stopped August 2002.
PSA on the 14/11/02 was 5.3 μg/l. More biopsies were taken which showed Gleason 3+3=6 carcinoma stage T1c.
He commenced radical radiotherapy which was completed on the 30/05/03 total dose of 55Gy in 20 daily fractions.
PSA on the 19/09/03 was 1.0 μg/l with a morning testosterone of 5.2 nmol/l. Therefore he commenced Testogel 25 mg daily in November 2003 with 3 monthly PSA levels.
PSA levels have ranged from 0.6 to 1.0 μg/l up to the present day with no cancer recurrence.
In February 2009 he changed to Tostran 30 mg daily and continues to have ongoing follow-up with the urologist and oncologist.
A literature review was undertaken exploring testosterone replacement therapy following treatment for prostate cancer, and concluded that testosterone therapy can be considered after radical treatment of prostate cancer by prostatectomy.
Conclusion: Testosterone replacement therapy isnt always contraindicated forever, in patients who have had prostate cancer.