Androgen replacement therapy after prostate cancer treatment.

Historically, testosterone supplementation has been avoided in men with a history of prostate cancer because of concern about prostate cancer progression or recurrence. However, recently published data suggest that this concern may not be well founded. The recurring presence of prostate-specific antigen in men with hypogonadism being treated with testosterone after prostatectomy is far less than the expected natural recurrence rate of the disease. There are many theories (including the prostate saturation theory) that may help us understand why testosterone may be safely administered in men with hypogonadism after surgical treatment of prostate cancer. Finally, because patients with hypogonadism already may be at a significant disadvantage in recovering their erectile function after prostatectomy, they perhaps should receive special consideration as candidates for androgen replacement therapy.