Testosterone Therapy in Oncologic Patients

Purpose of Review Testosterone deficiency (TD) disproportionately affects men with cancer due to several risk factors, including treatments and direct physiologic effects of the cancer disease process. Research and formal guidelines to aid physicians in diagnosing and treating TD in cancer patients are limited, causing this population to be grossly under-treated. There is an opportunity to safely treat these patients and positively impact several aspects of quality of life. Recent Findings While the treatment of TD has been well studied in non-oncologic patients, studies in cancer patients are limited and include retrospective, observational, pilot, and randomized-controlled trials. Summary Cancer patients have a high symptom burden, many of which may overlap with symptoms of TD. Treatment of TD in cancer patients may provide benefit in various aspects of health including functional outcomes, quality of life, and cancer-induced cachexia. Given the impact of TD in cancer patients, the authors believe it reasonable to assess for TD in men with cancer and hypogonadal symptoms and consider trial of TRT as a shared decision-making approach with close monitoring of adverse events and side effects.