Young male cancer survivors may benefit from testosterone replacement

In young male cancer survivors with low testosterone levels, testosterone replacement therapy is associated with an improvement in body composition, according to a new study published this week in PLOS Medicine by Richard Ross of University of Sheffield, UK, and colleagues.

Young male cancer survivors have lower testosterone levels than the healthy population, associated with increased trunk fat mass and worse quality of life than matched controls. In the new study, researchers randomized 136 male cancer survivors aged 25 to 50 years old with borderline low testosterone levels to either receive a placebo gel or Tostran 2% testosterone gel. Participants applied the gel to their skin daily for 26 weeks.

At the conclusion of the study period, men treated with testosterone had an average decrease of 1.8 kg fat mass (95% CI -2.9 to -0.7, p=0.0016) and an average increase of 1.5 kg lean mass (95% CI 0.9 to 2.1, p<0.0001) compared to placebo. The decrease in fat mass was greatest in those with the highest truncal fat mass at baseline. Despite the change in body composition, there was no effect on quality of life as measured by a questionnaire.

"This study provides a relevant evidence base for clinicians faced with a young adult male cancer survivor with borderline low testosterone level," the authors say. "We suggest that in these patients testosterone replacement be considered in the context of other interventions to improve body composition."