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Review
. 2017 Jun;11(6):204-209.
doi: 10.5489/cuaj.4539.

Testosterone monitoring for men with advanced prostate cancer: Review of current practices and a survey of Canadian physicians

Bobby Shayegan  1 , Frédéric Pouliot  2 , Alan So  3 , John Fernandes  4 , Joseph Macri  4
Affiliations
Review

Testosterone monitoring for men with advanced prostate cancer: Review of current practices and a survey of Canadian physicians

Bobby Shayegan et al. Can Urol Assoc J. 2017 Jun.

Abstract

Androgen-deprivation therapy (ADT) is a standard of care in the treatment of advanced prostate cancer; however, testosterone monitoring practices for men undergoing ADT vary across Canada. Although a testosterone level of 1.7 nmol/L or lower has historically been defined as the accepted castrate level, newer assays with improved sensitivity have shown that both medical and surgical castration can suppress testosterone levels to below 0.7 nmol/L. This review explores the evidence supporting a redefinition of the castrate testosterone level as 0.7 nmol/L or lower, and presents results of a survey of testosterone monitoring practices among 153 Canadian urologists, uro-oncologists, and radiation oncologists who manage the treatment of men with hormone-sensitive prostate cancer.

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Conflict of interest statement

Competing interests: Dr. Pouliot has been an advisor for Amgen, Astellas, and Pfizer; a speaker for Sanofi; and has received payment/grants/honoraria from Amgen, Astellas, AstraZeneca, Janssen, Pfizer, and Sanofi. Dr. So has been a speaker for Amgen, Astellas, and Janssen. The remaining authors report no competing personal or financial interests.

Figures

Fig. 1
Fig. 1
Approach to testosterone monitoring among Canadian urologists, radiation oncologists, and uro-oncologists A) at the initiation of continuous androgen-deprivation therapy (ADT); and B) with ongoing treatment, assuming that prostate-specific antigen (PSA) levels are as expected. LHRH: luteinizing hormone-releasing hormone.
Fig. 2
Fig. 2
Time to castrate-resistant prostate cancer (CRPC) by nadir testosterone (T) within the first year of androgen-deprivation therapy in a secondary analysis of the PR-7 trial. CI: confidence interval; HR: hazard ratio.
Fig. 3
Fig. 3
(A) Types; and (B) lower limit of testosterone detection of testosterone monitoring assays used among Canadian urologists, radiation oncologists, and uro-oncologists.
See this image and copyright information in PMC

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