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Pituitary-testis axis dysfunction following adjuvant androgen deprivation therapy
Julie Abildgaard1,2,3, Hein Vincent Stroomberg4, A Kirstine Bang1,2
1Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Endocrine-Related Cancer
|November 10, 2022
Summary
Persistent testosterone deficiency is common after prostate cancer treatment with androgen deprivation therapy (ADT). This study found pituitary and testicular dysfunction equally affect prostate cancer survivors long-term after ADT cessation.
Area of Science:
- Endocrinology
- Oncology
- Urology
Background:
- Adjuvant androgen deprivation therapy (ADT) is standard for high-risk, non-metastatic prostate cancer.
- Long-term effects of ADT on pituitary-testis axis function post-treatment are not well understood.
Purpose of the Study:
- To investigate the function of the pituitary-testis axis after cessation of adjuvant ADT in prostate cancer patients.
- To identify the prevalence and type of testosterone deficiency (TD) following ADT.
Main Methods:
- Included 51 men treated with radiation and ADT for prostate cancer.
- Assessed TD symptoms, biochemical markers, and performed dynamic GnRH and hCG stimulation tests.
- Classified TD as primary, secondary, or mixed based on hormonal responses.
Main Results:
- Median ADT duration was 3.2 years, with a median follow-up of 3.8 years post-cessation.
- Twenty-eight patients (55%) were diagnosed with persistent TD.
- TD was equally distributed between primary (testicular), secondary (pituitary), and mixed dysfunction.
Conclusions:
- Persistent testosterone deficiency is a frequent long-term outcome of adjuvant ADT in prostate cancer survivors.
- Both pituitary and testicular functions are commonly impaired, necessitating systematic monitoring.
- Follow-up of the entire pituitary-testis axis is crucial for managing ADT-treated patients.
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