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Hypogonadism and cancer survivorship
Cory A Faw1, Robert E Brannigan
1Northwestern University, Feinberg School of Medicine, Department of Urology, Chicago, Illinois, USA.
Purpose Of Review:
Hypogonadism is highly prevalent among not only patients with a history of prior treatment for cancer, but also among those patients with a new oncologic diagnosis who have not yet received any cancer therapy. Hypogonadism can cause a wide array of signs and symptoms including: deceased muscle mass; increased fat mass; decreased energy, mood, and overall sense of well being; diminished bone mineral density; infertility; and impaired libido and sexual function. This purpose of this manuscript is to review the mechanisms by which cancer and oncologic treatment regimens can adversely affect the hypothalamic pituitary gonadal axis, resulting in hypogonadism. Risks and benefits associated with the treatment of testosterone deficiency are also discussed, which are important considerations for clinicians caring for affected patients.
Recent Findings:
Hypogonadism has a high prevalence in the setting of cancer and is an important survivorship issue. Recent randomized controlled trials confirm testosterone's therapeutic benefits in terms of sexual function, mood body composition, and bone health, but the specific benefits in terms of quality of life are less clear.
Summary:
More prospective studies are needed to further delineate the risks, benefits, and overall outcomes of testosterone replacement therapy in patients with cancer and cancer survivors.
Insights
Hypogonadism is common in cancer patients and survivors, impacting mood, body composition, and bone health. Testosterone therapy shows benefits, but more research is needed on risks and quality of life outcomes.
Area of Science:
- Oncology
- Endocrinology
- Men's Health
Background:
- Hypogonadism is highly prevalent in cancer patients, both before and after treatment.
- It presents with symptoms like decreased muscle mass, mood changes, and reduced bone density.
Purpose of the Study:
- To review how cancer and its treatments affect the hypothalamic pituitary gonadal axis, causing hypogonadism.
- To discuss the risks and benefits of treating testosterone deficiency in cancer patients.
Main Methods:
- Literature review of mechanisms affecting the hypothalamic pituitary gonadal axis.
- Analysis of recent randomized controlled trials on testosterone therapy.
Main Results:
- Testosterone therapy demonstrates benefits for sexual function, mood, body composition, and bone health.
- The impact on overall quality of life requires further investigation.
Conclusions:
- Testosterone replacement therapy offers therapeutic advantages for cancer patients and survivors.
- Further prospective studies are essential to fully understand the risks, benefits, and outcomes.
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