Endocrine Abstracts

Background: Men who receive gonadotoxic treatment for cancer may be at risk of hypogonadism. The extent of this risk is unknown. Severe hypogonadism is associated with fatigue, sexual dysfunction, reduced muscle mass and obesity. Diagnosing mild or moderate hypogonadism is difficult and requires evaluation.

Aim: The aim of this study was to identify hypogonadism in young male survivors of cancer.

Subjects and Methods: The study was approved by the local ethics committee. 176 male cancer survivors (mean age 37.3 y S.D. 5.75) who previously received gonadotoxic therapy and were more than 2 years since end of treatment, and 213 controls (mean age 36.3 y S.D. 6.0) with no previous history of cancer were recruited. Height (m), weight (kg), body mass index (BMI, kg/m²) and several biochemical markers were measured including total testosterone (tT), oestradiol (E₂), LH, FSH, SHBG, T₄, TSH, IGF-1. Free androgen index (FAI) and free oestrogen index (FEI) were also calculated. Comparisons were made by independent t-test using SPSS v11.

Results: There were no significant differences between survivors and controls for age, height, T_4, tT, E_2, FAI, FEI, SHBG and IGF-1. Cancer survivors were significantly heavier (88.9 vs 85.5 kg, P=0.011), with a greater BMI (27.6 vs 26.5, P=0.005). TSH was significantly higher (2.4 vs 1.9, P<0.001) suggesting hypothyroidism. FSH and LH were significantly higher (FSH 12.9 vs 3.9, P<0.001, LH 7.2 vs 4.8, P<0.001).

Conclusion: Cancer survivors may have subclinical hypogonadism and further analysis of fatigue, sexual function and detailed body composition is required.