Hormone fear for cancer survivors

Testosterone treatment may be warranted, say researchers

Men who beat cancer may struggle with the long-term effects of treatment on testosterone levels, scientists say.

Sheffield researchers checked 176 former patients, finding fatigue and sexual problems in those with the lowest levels of the sex hormone.

Writing in the journal Cancer, they called for hormone replacement treatment to be considered.

Cancer charity MacMillan said the safety of hormone use in former cancer patients would have to be checked.

We now need interventional trials with testosterone to determine which young male cancer survivors will benefit from replacement therapy Professor Richard Ross, Sheffield University

Studies have suggested that "testosterone deficiency", triggered by the effects of chemotherapy or radiotherapy, could affect up to 15% of male cancer survivors.

However, this study is the first to attempt to chart the long-term effects of the problem, and to try to separate them from the psychological effects of fighting the disease.

They compared the group of survivors - recruited on average two years after being given the "all-clear" - with 213 "controls" who had no history of cancer.

These were all younger patients, mostly in their 30s, who had suffered tumours which were unrelated to testosterone levels, such as lymphomas and leukaemia.

Quality of life scores were generally lower among the former cancer patients, but the difference was greater in those who also had testosterone deficiency.

They reported low energy levels and poorer sexual function, including reduced sexual desire and the ability to become aroused.

The problems could not be attributed to psychological distress or self-esteem problems in the wake of their illness, as their scores were comparable with the "control" subjects.

Common problem

Professor Richard Ross, who led the researchers, said that the relationship between testosterone levels was "complex".

He said: "This is an important study demonstrating that low testosterone levels are common in male cancer survivors and associated with an impaired quality of life.

"We now need interventional trials with testosterone to determine which young male cancer survivors will benefit from replacement therapy."

Stuart Danskin, from MacMillan, a charity which offers support to cancer patients and their families during and after treatment, said that while the concept of hormone imbalances was well recognised in some female cancers, it was a "relatively new phenomenon" among male patients.

He said: "We know that after treatment that patients can feel pretty low - we always used to think that was a psychological effect connected to having cancer itself, but now there is the possibility of hormones being involved."

However, he said that the potential of hormone replacement therapy in affected men would have to be carefully evaluated to make sure it was a safe option for patients.