Endocrine Abstracts

We present the case of a 62 year old gentleman who was diagnosed with Acromegaly in 1998.

He commenced testosterone replacement therapy in the form of Sustanon every three weeks in October 2000 following a testosterone level of 6.6 nmol/l.

PSA levels during treatment with Sustanon were: 01/03/01–5.1μg/l.

06/04/01–4.9 μg/l at which point he was referred for a urological opinion.

On the 13/02/02 he underwent prostate biopsies which were benign.

Sustanon was stopped August 2002.

PSA on the 14/11/02 was 5.3 μg/l. More biopsies were taken which showed Gleason 3+3=6 carcinoma stage T1c.

He commenced radical radiotherapy which was completed on the 30/05/03 – total dose of 55Gy in 20 daily fractions.

PSA on the 19/09/03 was 1.0 μg/l with a morning testosterone of 5.2 nmol/l. Therefore he commenced Testogel 25 mg daily in November 2003 with 3 monthly PSA levels.

PSA levels have ranged from 0.6 to 1.0 μg/l up to the present day with no cancer recurrence.

In February 2009 he changed to Tostran 30 mg daily and continues to have ongoing follow-up with the urologist and oncologist.

A literature review was undertaken exploring testosterone replacement therapy following treatment for prostate cancer, and concluded that testosterone therapy can be considered after radical treatment of prostate cancer by prostatectomy.

Conclusion: Testosterone replacement therapy isn’t always contraindicated forever, in patients who have had prostate cancer.