Prostate radiotherapy effects on testosterone levels: an empirical investigation

AbstractObjectiveThere is a paucity of clinical data to support the hypothesis that external beam radiation therapy causes iatrogenic hypogonadism in prostate cancer patients.MethodsAll prostate cancer patients treated at a single institution with radiation therapy between 2002 and 2010 were retrospectively evaluated. Patients treated with brachytherapy alone received 0  Gy of external beam radiation therapy and served as the control group. Patients treated with combination external beam radiation therapy + brachytherapy, or external beam radiation therapy alone were categorized into groups who received 45–54 Gy or>  60 Gy of external beam radiation therapy, respectively. Serum testosterone levels were routinely measured with prostate-specific antigen tests.ResultsThe median follow-up periods for 149 evaluable patients in the control group (0  Gy), the 45–54 Gy group, and>  60 Gy group were 57, 62, and 55 months, respectively (p = 0.43). Among patients who underwent external beam radiation therapy, 53% were treated with intensity-modulated radiation therapy, 65% with pelvic lymph node coverage, and 78% with 18 megavoltage photons. There were no differences in serum testosterone level declines over time between the 45– 54 Gy group (p = 0.32) or the>  60 Gy group (p = 0.14) when compared to the control group (0 Gy). While body mass index wa...
Source: Journal of Radiation Oncology - Category: Cancer & Oncology Source Type: research

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In this study, we evaluated the performance of multiparametric MRI (mpMRI) and mpMRI-TRUS fusion biopsy in hypogonadal patients.Materials and methodsClinical and pathologic data from a prospectively maintained, single-institution database of patients who underwent 3T mpMRI and fusion biopsy between 2007 and 2016 were analyzed. Hypogonadism was defined by an institutional cutoff of serum testosterone ≤ 180 ng/dL; T2, DWI, and DCE scores were calculated from mpMRI. Cancer detection rates were compared by Chi-square tests. Multivariate logistic regression was undertaken to evaluate the impact of hypogonadism on...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
To evaluate whether total serum PSA, free-PSA ratio and PSA density have similar diagnostic properties for detecting prostate cancer (PCa) and clinically-significant (cs) PCa in men with normal testosterone compared to men with low testosterone with a prior negative biopsy.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
Publication date: October 2019Source: European Urology Supplements, Volume 18, Issue 9Author(s): E. Mancini, C. De Nunzio, F. Esperto, M. Bellangino, R. Lombardo, A. Nacchia, A. Sica, F. Cancrini, A. Tubaro
Source: European Urology Supplements - Category: Urology & Nephrology Source Type: research
CONCLUSION: We propose seeking for hypogonadism caused by endocrine conditions or ADT in men presenting with TdP. Caution is warranted when ADT is used in situations at risk of TdP. Testosterone may be useful to treat or prevent TdP. PMID: 31477476 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
Several studies highlight that testosterone deficiency is associated and predicts increased risk of developing metabolic disorders, and, that it is highly prevalent in obesity, metabolic syndrome and type-2 diabetes mellitus. Models of gonadotropin releasing hormone deficiency and androgen deprivation in patients with prostate cancer suggest that hypogonadotropic hypogonadism might contribute to onset or further worsen metabolic conditions by means of increased fat mass and insulin resistance. Nevertheless, in functional hypogonadism, such as late onset hypogonadism, the relationship between hypogonadotropic hypogonadism a...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
CONCLUSIONS: In this systematic review and meta-analysis, we did not observe higher rate of BCR after TRT for nonmetastatic CaP patients after definitive local therapy. Based on these data, others and we have outlined a phase I/II trial assessing the safety and benefits of TRT in select men with secondary symptomatic hypogonadism who have no active disease after definitive local CaP therapy with curative intent. PMID: 31296421 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
CONCLUSION: The principal findings of this investigation were that low testosterone is correlated with elevated CgA levels, and these two parameters are associated with more aggressive grades and higher pathological stages of prostatic adenocarcinoma. KEY WORDS: Chromogranin A, Prostate cancer, Risk factor for prostate cancer, Testosterone. PMID: 31203267 [PubMed - as supplied by publisher]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Abstract OBJECTIVE: Our aim was to evaluate the usefulness of serum testosterone to guide treatment decision for castration-resistant prostate cancer (CRPC). METHODS: We conducted a retrospective analysis of 115 patients with CRPC treated with either abiraterone (n = 43) or enzalutamide (n = 72). A serum testosterone level was measured at time of starting of abiraterone or enzalutamide. We determined whether serum testosterone influenced the outcomes of androgen receptor (AR)-targeted therapy. RESULTS: In the very-low testosterone group (
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Purpose of review The aim of this study is to summarize recently published literature examining androgens and depression. Recent findings The impact of androgen levels, androgen replacement therapy and pharmacologic androgen deprivation on depression and depressive symptoms remain active areas of investigation. Recent publications support the finding that testosterone replacement therapy in men with low testosterone may improve depression, and that androgen deprivation therapy in men with prostate cancer may contribute to depression. Summary We review the recent literature on androgens and depression and highlight key developments.
Source: Current Opinion in Endocrinology, Diabetes and Obesity - Category: Endocrinology Tags: ANDROGENS: Edited by David Handelsman Source Type: research
Abstract Evidence has been accumulating that, in men, some of the biological actions traditionally attributed to testosterone acting via the androgen receptor may in fact be dependent on its aromatisation to estradiol (E2). In men, E2 circulates at concentrations exceeding those of postmenopausal women, and estrogen receptors are expressed in many male reproductive and somatic tissues. Human studies contributing evidence for the role of E2 in men comprise rare case reports of men lacking aromatase or a functional estrogen receptor alpha, short term experiments manipulating sex steroid milieu in healthy men, men wi...
Source: European Journal of Endocrinology - Category: Endocrinology Authors: Tags: Eur J Endocrinol Source Type: research
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