The literature suggests that the serum testosterone level required for maximum androgen receptor (AR) binding may be in the range of nanomolar and above this range of concentrations; this sexual hormone may not significantly affect tumour biology. This assumption is supported by clinical studies showing that cell proliferation markers did not change when serum T levels increased after exogenous T treatment in comparison to subjects treated with placebo. However, a considerable part of the global scientific community remains sceptical regarding the use of testosterone replacement therapy (TRT) in men suffering from hypogonadism and prostate cancer (Pca). The negative attitudes with respect to testosterone supplementation in men with hypogonadism and Pca may be justified by the relatively low number of clinical and preclinical studies that specifically dealt with how androgens affect Pca biology. More controversial still is the use of TRT in men in active surveillance or at intermediate or high risk of recurrence and treated by curative radiotherapy. In these clinical scenarios, clinicians should be aware that safety data regarding TRT are scanty limiting our ability to draw definitive conclusions on this important topic. In this review we critically discuss the newest scientific evidence concerning the new challenges in the treatment of men with hypogonadal condition and Pca providing new insights in the pharmacological and psychological approaches.

Challenges to treat hypogonadism in prostate cancer patients: Implications for endocrinologists, urologists and radiotherapists / Gravina, Giovanni L.; DI SANTE, Stefania; Limoncin, Erika; Mollaioli, Daniele; Ciocca, Giacomo; Carosa, Eleonora; Sanità, Patrizia; Di Cesare, Ernesto; Lenzi, Andrea; Jannini, Emmanuele A.. - In: TRANSLATIONAL ANDROLOGY AND UROLOGY. - ISSN 2223-4683. - STAMPA. - 4:2(2015), pp. 139-147. [10.3978/j.issn.2223-4683.2015.04.01]

Challenges to treat hypogonadism in prostate cancer patients: Implications for endocrinologists, urologists and radiotherapists

DI SANTE, STEFANIA;Limoncin, Erika;Ciocca, Giacomo;LENZI, Andrea;
2015

Abstract

The literature suggests that the serum testosterone level required for maximum androgen receptor (AR) binding may be in the range of nanomolar and above this range of concentrations; this sexual hormone may not significantly affect tumour biology. This assumption is supported by clinical studies showing that cell proliferation markers did not change when serum T levels increased after exogenous T treatment in comparison to subjects treated with placebo. However, a considerable part of the global scientific community remains sceptical regarding the use of testosterone replacement therapy (TRT) in men suffering from hypogonadism and prostate cancer (Pca). The negative attitudes with respect to testosterone supplementation in men with hypogonadism and Pca may be justified by the relatively low number of clinical and preclinical studies that specifically dealt with how androgens affect Pca biology. More controversial still is the use of TRT in men in active surveillance or at intermediate or high risk of recurrence and treated by curative radiotherapy. In these clinical scenarios, clinicians should be aware that safety data regarding TRT are scanty limiting our ability to draw definitive conclusions on this important topic. In this review we critically discuss the newest scientific evidence concerning the new challenges in the treatment of men with hypogonadal condition and Pca providing new insights in the pharmacological and psychological approaches.
2015
Hypogonadism; Prostate cancer (Pca); Psychotherapy; Radiotherapy; Testosterone; Treatment; Reproductive Medicine; Urology
01 Pubblicazione su rivista::01a Articolo in rivista
Challenges to treat hypogonadism in prostate cancer patients: Implications for endocrinologists, urologists and radiotherapists / Gravina, Giovanni L.; DI SANTE, Stefania; Limoncin, Erika; Mollaioli, Daniele; Ciocca, Giacomo; Carosa, Eleonora; Sanità, Patrizia; Di Cesare, Ernesto; Lenzi, Andrea; Jannini, Emmanuele A.. - In: TRANSLATIONAL ANDROLOGY AND UROLOGY. - ISSN 2223-4683. - STAMPA. - 4:2(2015), pp. 139-147. [10.3978/j.issn.2223-4683.2015.04.01]
File allegati a questo prodotto
File Dimensione Formato  
Gravina_challenges-treat-hypogonadism_2015.pdf

accesso aperto

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 130.3 kB
Formato Adobe PDF
130.3 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/880041
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 4
social impact