Testosterone Treatment After Radical Prostate Removal

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Nelson Vergel

Founder, ExcelMale.com
EAU 2019: Case Based Debate: Hypogonadal Prostate Cancer Patient Following Treatment with Curative Intent: Pro versus Con


Barcelona, Spain (UroToday.com) In this debate, Drs. Mulhall and Tombal debated the safety of testosterone replacement therapy in a prostate cancer patient. The index patient was a 58-year-old male with a pre-treatment PSA of 7.6 who, was 6 months status post radical prostatectomy for Gleason 4+3 prostate cancer with negative margins and an undetectable PSA, but symptomatic hypogonadism and erectile dysfunction despite tadalafil 5mg daily. It was noted that physicians concerns regarding testosterone replacement therapy are worldwide, stemming from the original Huggins and Hodges data that reduction of testosterone to castrate levels caused prostate cancer to regress whereas administration of exogenous testosterone caused prostate cancer to grow. However, more contemporary data shows no strong evidence on testosterone replacement therapy and prostate cancer and current EAU evidence-based guidelines is listed as “weak”.
Dr. Mulhall argued in favor of administering testosterone replacement therapy in the post-prostatectomy patient. Story continues here
 
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