Testosterone Therapy in Men With Localized Prostate Cancer

[摘要] One of the major clinical dilemmas facing urologists who see patients with prostate cancer is what to do with them after they become hypogonadal, either biochemically or symptomatically. It is known that as men age, the incidence of hypogonadism increases at the same time that the incidence of prostate cancer increases. Ever since Huggins and Hodges showed the link between testosterone and prostate cancer more than 6 decades ago,1 it is considered verboten to treat anyone who has a diagnosis of prostate cancer with exogenous testosterone, regardless of whether or not they are hypogonadal. Indeed, all forms of testosterone carry such a warning label, and there have been very few reports attesting to the fact that treatment of men who have localized prostate cancer with exogenous testosterone causes a flare of the cancer. This is in contradistinction to men who have metastatic disease where the treatment with LHRH agonists can cause such a flare, which is presumed to be due to the transient elevation of the serum testosterone right after initiation of LHRH agonist treatment.

[学科分类] 基础医学