Testosterone Treatment of Men with Unequivocal Hypogonadism Following Treatment of Organ-Confined Prostate Cancer.

None of the 16 men with unequivocal hypogonadism who received testosterone treatment after radical prostatectomy for organ-confined prostate cancer experienced biochemical recurrence.

• Biochemical recurrence was defined by a prostate-specific antigen level of ≥0.2 ng/mL.
• The median duration of testosterone treatment and monitoring was 5 years (range, 1-20 years).
• Zero of 16 men showed evidence of cancer recurrence during the monitoring period.
• Baseline serum testosterone concentrations in the 16 men ranged from 9 to 185 ng/dL.

A stringent set of inclusion criteria was applied to identify men who were unequivocally hypogonadal prior to prostate cancer diagnosis.

• Men were required to have at least 1 morning serum testosterone concentration of ≤220 ng/dL prior to prostate cancer diagnosis.
• Men must have discontinued testosterone treatment when prostate cancer was diagnosed and resumed within 2 years after treatment.
• Men were required to have been treated by radical prostatectomy with no evidence of extraprostatic extension.
• Of 269 men aged ≥50 years identified via electronic medical records search (January 1, 2005 to September 20, 2021) with both prostate cancer and hypogonadism diagnoses, only 16 met all inclusion criteria.

Prior studies of testosterone treatment in men with treated prostate cancer have not documented that the men were unequivocally hypogonadal.

• The testosterone dependence of metastatic prostate cancer has made physicians reluctant to treat hypogonadal men with testosterone even after treatment of prostate cancer.
• The authors identified this gap in prior literature as a key motivation for the current study.
• The current study required a documented morning serum testosterone of ≤220 ng/dL as objective evidence of unequivocal hypogonadism prior to cancer diagnosis.

The study population was identified through a computerized search of electronic medical records spanning over 16 years.

• The search covered January 1, 2005, to September 20, 2021.
• The initial search identified 269 men aged ≥50 years diagnosed with both prostate cancer and hypogonadism.
• Individual records were reviewed to identify those treated by radical prostatectomy with no evidence of extraprostatic extension.
• Only 16 men ultimately met all inclusion criteria after individual record review.