After the fourth decade of life the total
testosterone level in men decreases continually. If clinical symptoms, such as decreased libido or
erectile dysfunction are combined with a decreased serum
testosterone level this is known as late onset
hypogonadism (LOH) or partial
androgen deficiency in the aging male (PADAM). In such cases
testosterone substitution
therapy is indicated. One important question is how to treat patients suffering from LOH but also have
prostate cancer which was treated curatively in the past? Only relatively little data are available with small numbers of patients which show that
testosterone substitution
therapy is possible without an increased risk of a relapse in cases of cured
prostate cancer. If the patient was cured it does not matter if radical
prostatectomy or
radiation therapy was used. It is mandatory that patients are well-informed about substitution
therapy and that regular surveillance and controls are carried out during the
therapy. For patients who still have
prostate cancer which has not yet been treated or not yet cured decisions on whether the benefit of the
testosterone replacement is greater than the potential risk of a progress of the disease have to be made on an individual case-specific basis.