Young male cancer survivors may significantly benefit from testosterone replacement therapy—especially after testicular cancer. Research published by Walsh et al in PLOS Medicine looked at one of the most common late-onset side effects experienced by young male survivors—reduced levels of the male sex hormone.
Low levels of testosterone can be caused by cancer and therapies such as chemotherapy and radiotherapy. It can cause problems that impact the health of cancer survivors, including changes in body composition; young men with low testosterone levels carry, on average, more fat mass and less lean body mass than their peers, which is linked with a higher risk of conditions like heart disease.
Senior study author Richard Ross, MD, FRCP, of the University of Sheffield, said, “Cancer and its treatment can be life-altering, leaving patients feeling unwell and low in mood. Most cancer research studies are focused on developing or improving cancer therapies, so this study is a great step forward for cancer survivors. It’s the first of its kind to investigate a treatment for one of the late effects of cancer, and [translating] our research into clinical evidence will support doctors and their patients’ recovery from cancer.”
Methods and Findings
The clinical trial was the first randomized, double-blind, placebo-controlled study of testosterone replacement in survivors with borderline low testosterone levels. Over 6 months, 136 men aged 25 to 50 were randomly assigned 1:1 to receive either testosterone replacement therapy or placebo. Among these men, 9 out of 10 had been treated for testicular cancer.
Testosterone treatment compared with placebo was associated with decreased trunk fat mass (−0.9 kg, 95% confidence interval [CI] = −1.6 to −0.3, P = .0073), decreased whole-body fat mass (−1.8 kg, 95% CI = −2.9 to −0.7, P = .0016), and increased lean body mass (1.5 kg, 95% CI 0.9–2.1, P < .001). Decrease in fat mass was greatest in those with high levels of fat around their waists, which is associated with higher risk of conditions like heart disease later in life.
“These late effects of cancer on the health of cancer survivors are increasingly being recognized,” added Dr. Ross. “The results of this study have significant benefits alongside improvements in body composition, potentially offsetting the risk of increased mortality from heart disease.”
The study authors concluded, “In young male cancer survivors with low-normal morning total serum testosterone, replacement with testosterone is associated with an improvement in body composition.”
Disclosure: For full disclosures of the study authors, visit journals.plos.org.
