Testosterone recovery linked to overall survival in high-risk prostate cancer

Medical Xpress / HealthDay / Am Soc of Clinical Oncology annual Genitourinary Cancers Symposium ^ | Feb. 18, 2025 | Elana Gotkine / Abdenour Nabid, M.D. et al

[ConservativeMind]

Serum testosterone (T) recovery to normal levels is associated with a significant improvement in overall survival in patients with high-risk prostate cancer receiving radiotherapy and long-term androgen deprivation therapy (ADT), according to a study.

Abdenour Nabid, M.D. and colleagues randomly assigned 630 patients with high-risk prostate cancer to pelvic radiotherapy plus 36 versus 18 months of ADT (310 and 320 patients, respectively). Serum T was collected at baseline and regularly thereafter. T recovery was defined as return of T to within the normal range value of each participating institution. T data were available for 515 patients who were retained for the analysis.

Overall, 6,587 T measurements were available during a period of 22 years (median follow-up, 17.4 years). The researchers found that 52.4% of patients recovered T to normal levels: 57.0 and 44.3% in the 18- and 36-month cohorts, respectively. Patients not recovering T to a normal level were older, had higher clinical stage, and had diabetes.

The median time to T recovery was 3.6 years among patients regaining T to a normal level. The 10- and 15-year overall survival rates were 76 and 44%, respectively, among those recovering T versus 55 and 30%, respectively, for those not recovering T. When considering the global hazard ratio, a significantly lower risk for death favored patients recovering T (hazard ratio, 0.54).

"The increased death rate in patients not recovering T is likely due to causes unrelated to prostate cancer," the authors write.

[ConservativeMind]

Getting testosterone back to normal helps men live longer, when treated for high-risk prostate cancer.

[ConservativeMind]

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[Dr. Sivana]

For men who do not have prostate cancer, isn’t restoring testosterone levels a bit trickier?

[stockpirate]

Bump

[trebb]

Interesting - I was told that prostate cancer fed off testosterone...

[Arlis]

NOT understanding this.

I had Gleason 7 prostate cancer 5 years ago, successfully killed by Tulsa Pro non-invasive procedure and have been cancer-free ever since.

I was on T-shots for low T for over 10 years, and was told by many experts that the testosterone FEEDS prostate cancer.

And all radiation I investigated included androgen therapy that lowers T to zero. Also results in men having symptoms of menopause.

I still have way below normal T and the natural resultant lack of energy.

This study says that after the radiation treatment that the mens T-levels returned to normal?

I’d love to get back on T-shots to boost my energy but risk is too high. I am 80.

Any help understanding this study is appreciated.

[ConservativeMind]

This is saying that androgen deprivation therapy can be done only for a certain number of months to accomplish what is needed.

[Arlis]

Thank you.

So the T-levels return naturally? and the testosterone no longer will feed any remaining cancer? Or the cancer is totally gone so the T is no longer a threat?

[ConservativeMind]

As I read it, the T-levels were allowed to return naturally, because the androgen deprivation therapy was stopped at 18 or 36 months—seemingly because the cancer was not back.

It also seems testosterone coming back or not was tied to overall survival rates. In people in which it came back (naturally), they did better.

It doesn't seem to talk to adding testosterone, though.

This is how I read the item.

[sauropod]

Bkmk.