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Bad science: “Data: May be OK to give ‘T’ to men with prostate cancer”

Hyperlink to the article: http://www.medscape.com/viewarticle/869126#vp_2

Author’s Conclusion

            “In testosterone deficient men with a history of treated or untreated CaP testosterone therapy resulted in increases in serum testosterone levels with a small but significant increase in PSA. These findings are similar to what is seen in the literature currently and they are explained by the saturation model proposed by others. While our rates of BCR were lower than clinical norms, our trial design did not allow for comment on causative factors. It is important to recognize the limitations of the retrospective nature of the current study. Future results from randomized, controlled trials could lead to a change in our current treatment approach. Until these studies are completed, the use of TT among hypogonadal men with treated CaP or on AS should be monitored closely with serial PSA measurements and involve a detailed discussion of the potential risks and benefits with the patient prior to initiation of therapy.”

Student’s Conclusion (Jordan Carrillo)

                The study aimed to assess the effects of testosterone therapy in hypogonadal men with prostate cancer. The results that were calculated showed that those men in the active surveillance group showed the highest prostate specific antigen velocity at 1.1mcg/L per year, while the prostectomy and radiation therapy groups showed a mean PSA velocity of 0.001 and 0.12 mcg/L per year respectively. The presentation of these results led the author of the study to say “Treatment with testosterone may be oncologically safe” Although the data does not show any adverse reactions, the lack of beneficial effects and a placebo group make it difficult to support this study conclusive. There is still more research that needs to be done in order for this information to be applied in a clinical practice setting without physicians feeling uneasy about this recommendation.