The development of prostate cancer despite late onset androgen deficiency

Androgen withdrawal causes the regression of prostate cancer and is used in therapy, but the role of androgens in the development of prostate cancer is uncertain. We present a case of prostate cancer diagnosed in a man who had been clinically androgen deficient for some years. This case and reviewed literature suggest that while early androgen exposure may be important in the prostatic carcinogenesis, late onset androgen deficiency is not protective. Thus, hypogonadal men considering androgen replacement therapy need to be adequately counseled, screened for prostate cancer and followed closely during treatment.