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Would you ever recommend testosterone replacement for men with incomplete T recovery after ADT for prostate cancer?

Patient has ED unresponsive to cialis/viagra; would you recommend testosterone replacement therapy?
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Do you provide testosterone replacement for prostate ca patients whose testosterone does not fully recover post ADT?

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5 Answers
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Radiation Oncology · University of Miami Miller School of Medicine
Answered on

I have been hesitant to agree to supplemental testosterone after prostate cancer treatment, especially within the first few years. Prostate biopsies during that time often show atypical cells that are suspicious or adenocarcinoma with treatment effect. Androgens are pro-survival and the full effects...

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Radiation Oncology · Beth Israel Deaconess Medical Center/Harvard Medical School
Answered on

The concern that T replacement is “pouring gasoline” on the cancer is not supported by the evidence and makes no logical sense. The fact that metastatic disease is treated with ADT does not mean patients after treatment for localized disease should not be returned to normal T levels if needed.

Ther...

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Radiation Oncology · Oakland University William Beaumont School of Medicine
Answered on

I will consider androgen supplementation. If a patient recovers their testosterone, we say great. However, it is rare that they don’t and even rarer that a patient really would meet the criteria I would offer it.

I would wait for 24+ mo for a patient to demonstrate a failure to recover (and then eve...

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Radiation Oncology · Coastal Radiation Oncology
Answered on

Over the years, I have noted a tendency for some urologists to overtreat men with favorable intermediate CaP with extended courses of ADT and a tendency to treat older men with less aggressive cancer with ADT. Both populations suffer variable and prolonged side effects and potentially benefit from t...

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Radiation Oncology · Lafayette Radiation Center
Answered on

Depends on risk, decipher, time since Tx, PSA kinetics, and the patient's reason for getting T (won't give erections).
Recent data appears safe, but oncolore says not to give.
Case by case but rarely ever actually give it.

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