Androgen replacement and quality of life in patients treated for bilateral testicular cancer

Gonadal hormones and quality of life (QL) were assessed in bilaterally orchiectomised patients with testicular cancer who received intramuscular androgen replacement (ARP). 43 patients were to have serum analyses of testosterone LH, FSH and SHBG, preferably performed at the end of the interval between two intramuscular injections. They also completed a QL questionnaire consisting of the EORTC QLQ-C30, GHQ-28, LES and FATS (sexuality). 17 of 31 evaluable patients had subnormal testosterone levels, and 9 highly elevated LH. Blood levels indicating hypogonadism were more often observed in the 25 patients whose ARP was scheduled at greater than or equal to 3 week intervals than in the 18 patients with less than or equal to 2 weeks between ARP injections. A total of 11 patients reported hot flushes. The patients' QL was similar to that of a control group. However, 8 (20%) patients were Leases) according to GHQ-28/IES, independent of their hormone levels. Current standard intramuscular ARP is not optimal in approximately 1/3 of the patients who have undergone bilateral orchiectomy for testicular cancer, particularly if scheduled at greater than or equal to 3 week intervals. Schedules for ARP have to be improved. In spite of intermittent hypogonadism most patients are psychosocially and sexually well adjusted to their health situation. (C) 1999 Elsevier Science Ltd. All rights reserved.