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In Older Men, Testosterone Therapy Doesn’t Increase Risk of Prostate Cancer

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In Older Men, Testosterone Therapy Doesn’t Increase Risk of Prostate CancerMen who undergo testosterone replacement therapy (TRT) to treat age-related low testosterone are not at higher risk for prostate cancer, according to research in the American Journal of Epidemiology.

Typically, TRT guidelines advise against the use of TRT in men who have either had prostate cancer in the past or are at risk for it in the future. The hormone testosterone can fuel the growth of prostate cancer cells.

It was unclear whether taking testosterone increased a man’s risk for prostate cancer, however.

TRT is often prescribed to men with low testosterone. (The medical term for this condition is hypogonadism.) The treatment is approved for men whose bodies cannot produce enough testosterone on their own, usually due to problems with the testes (the glands that make this hormone) or areas of the brain that trigger testosterone production.

However, men’s bodies gradually start producing less testosterone as they get older. Eventually, men might start feeling fatigued, moody, and less interested in sex. Some doctors prescribe TRT “off-label” to treat these symptoms. (Off-label treatments can help certain conditions, but aren’t approved by a regulatory agency for that purpose.)

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Men's Sex

Peyronie’s Disease: More Men Receiving CCH Injections

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Peyronie’s Disease: More Men Receiving CCH Injections Nowadays, more men with Peyronie’s disease are being treated with injections of collagenase clostridium histolyticum (CCH) than surgery, according to recent research.

Peyronie’s disease is characterized by plaques of hardened scar tissue that form on the penis, just below the skin’s surface. The plaques make the penis lose some of its flexibility. As a result, the penis starts to bend. Sometimes, the curve is so severe that intercourse is difficult. Men with Peyronie’s disease may also experience pain and erectile dysfunction (ED).

Surgery to correct the curve is a common treatment. CCH injections, which are targeted directly at the plaques, were approved in 2014.

The study findings are based on insurance claims data for 36,156 men who were first diagnosed with Peyronie’s disease between 2011 and 2017. Diagnosis rates did not change much during that period.

In 2014, the treatment rate with either CCH or surgery was 9.8%, but the rate rose to 15.5% by 2017, reflecting an increase in men undergoing CCH injections. After CCH injections were approved, their use as a first-line treatment increased an average of 1.6% per year.

The ratio of CCH to surgery as a first-line treatment increased from 1:1 in 2014 to about 2:1 by 2017.

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Low Testosterone Common in Germ Cell Tumor Survivors

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Low Testosterone Common in Germ Cell Tumor SurvivorsIn a recent study of germ cell tumor survivors, roughly half had hypogonadism – low testosterone – regardless of whether they were treated with surgery alone or surgery with platinum-based chemotherapy, scientists report in the journal Supportive Care in Cancer.

However, patients who had chemotherapy added to their surgical treatment were more likely to have male aging symptoms.

Germ cells are reproductive cells: egg cells in females and sperm cells in males. Tumors form when these cells grow and accumulate in an abnormal way. Some germ cell tumors are cancerous. When they are, they usually develop into ovarian cancer or testicular cancer.

The study included 199 germ cell tumor survivors between the ages of 18 and 50. Each participant completed a quality of life questionnaire at the start of the study and again three and six months later.

About 48% of the entire group had low testosterone. (For this study, hypogonadism was diagnosed if a man’s testosterone levels were below 300 ng/dL.)

Next, the researchers looked at testosterone levels based on type of treatment. Among patients who had had both surgery and chemotherapy, the low testosterone rate was 51%. For those who had surgery alone, the rate was 45%.

Patients who had low testosterone levels were more likely to have reported fatigue, poor sleep quality, and worse general health at the start of the study.

When the scientists compared quality of life assessment scores for the two groups, they found no statistically significant differences. However, those who had had both surgery and chemotherapy “exhibited more symptoms related to male aging.”

Resources

Mayo Clinic

“Germ cell tumors”

(May 25, 2019)

https://www.mayoclinic.org/diseases-conditions/germ-cell-tumors/symptoms-causes/syc-20352493

Oncology Learning Network

Porcelli, Hina

“Surgery With or Without Chemo Yields Low Testosterone in GCT Survivors”

https://www.oncnet.com/news/surgery-or-without-chemo-yields-low-testosterone-gct-survivors

Ovarian Cancer Research Alliance

“Chemotherapy”

https://ocrahope.org/patients/about-ovarian-cancer/treatment/chemotherapy/

Supportive Care in Cancer

Khanal, N., et al.

“The effects of hypogonadism on quality of life in survivors of germ cell tumors treated with surgery alone versus surgery plus platinum-based chemotherapy”

(Abstract. Published: November 9, 2019)

https://link.springer.com/article/10.1007/s00520-019-05117-0

WebMD

“What Are Germ Cell Tumors?”

(Reviewed: October 12, 2019)

https://www.webmd.com/cancer/germ-cell-tumors#1

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Men With Both Peyronie’s Disease and Erectile Dysfunction Have Surgical Options

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Men With Both Peyronie’s Disease and Erectile Dysfunction Have Surgical OptionsMany men with Peyronie’s disease also develop erectile dysfunction (ED – the inability to get an erection firm enough for sex). It’s possible to surgically treat both conditions, and a new study in Sexual Medicine describes some of the latest research in this area.

Peyronie’s disease is a connective tissue disorder thought to occur when an injury to the penis doesn’t heal properly. Instead, areas of hardened scar tissue called plaques form on the penis, just below the surface of the skin. The plaques make the penis less flexible and can cause deformities like a distinct curve or a “hinge” effect. Intercourse can become quite difficult.

Peyronie’s disease generally develops in two stages. During the first (acute) stage, men may notice their penis starting to bend, and pain is common. After six to twelve months, the chronic (stable) phase begins, when pain goes away and the curve remains stable.

Surgery to straighten the penis is a frequent treatment for men with Peyronie’s disease, but it often isn’t performed until the chronic stage. Men who develop ED along with Peyronie’s disease may opt for a penile prosthesis that allows them to have an erection when they wish by activating their implant.

For the study, researchers analyzed 58 studies related to Peyronie’s disease with co-existing ED.

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