Presentation Authors: John Mulhall*, Nicole Benfante, New York, NY, Patrick Teloken, Dutton Park, Australia, Boback Berookhim, Lawrence Jenkins, New York, NY
Introduction: The role of testosterone (T) therapy in men with prostate cancer is debated. There is a paucity of long-term data in men on active surveillance (AS) for prostate cancer. This analysis attempted to define the safety of T therapy in this population.
Methods: Men on active surveillance for prostate cancer who had T deficiency constituted the study population. Men were treated with exogenous T (topical, intramuscular) agents or clomiphene if they had low or low-normal LH levels. T dose was titrated to achieve a serum level in the middle tertile of the reference range. Patients had serum T levels checked every 6 months and PSA levels checked every 3 months in the first year and every 6 months thereafter.
Results: A total of 86 patients have been prescribed T therapy to date. Mean age and pre-RP PSA levels were 55Â±11 years and 5Â±2 ng/dl respectively. Baseline total T levels were 240Â±60 ng/dl. 92% had a Gleason Score (GS) of 6, 8% had GS 7 disease. Mean duration on AS before T therapy was commenced was 13Â±15 months. Post-treatment total T levels were 515Â±190 ng/dl. Mean duration on T supplementation at last follow-up was 19Â±21 months. Mean PSA level change per patient was 0.6Â±0.3 nd/dl with 26% of men experiencing a PSA level increase â‰¥1 (70% baseline total T levels < 200 ng/dl). 16% of men on T therapy opted for definitive therapy for their prostate cancer.
Conclusions: These data suggest that T therapy does not result in significant PSA changes in men on active surveillance for prostate cancer. The rate of progression definitive therapy was similar to previously reported data.