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 24 May 2018

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News

Symptomatic hypogonadism in male cancer survivors

Survivors of cancer with chronic opioid exposure experience symptomatic hypogonadism with high levels of depression, fatigue, and sexual dysfunction, find physicians in the latest issue of Cancer.

News image

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Profound hypogonadism has been seen in patients receiving intrathecal opioids.

In this study, physicians from Houston, Texas, matched 20 patients who were chronically consuming opioids were compared with 20 matched controls.
90% of patients exhibited hypogonadism.
Cancer

The team determined whether chronic consumption of oral opioids by male cancer survivors leads to central hypogonadism. They also assessed whether this hypogonadism was associated with symptoms of sexual dysfunction, fatigue, anxiety, and depression.

Patients completed several questionnaires:

  • The Sexual Desire Inventory (SDI).
  • The Hospital Anxiety and Depression Scale (HADS).
  • The Functional Assessment of Chronic Illness Therapy with general and fatigue subscales (FACT-G/FACIT-F)
  • And the Edmonton Symptom Assessment System (ESAS).

The physicians tested serum samples for testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).

The team found that 90% of patients exhibited hypogonadism, compared with 40% of the controls.

They determined that the median testosterone level was 145 ng/dL in patients, compared with 399.5 ng/dL in the controls.

The median FSH and LH levels were also lower in the patients, compared with the controls.

The physicians found that the patient group scored significantly worse than the control group in all 4 questionnaires:

  • Median SDI-dyadic score = 18.5 (patients) versus 40 (controls) (P = 0.01).
  • Median SDI-solitary score = 0 versus 5 (P = 0.007).
  • HADS anxiety score = 8.5 versus 5.5 (P = 0.053).
  • HADS depression score = 7.5 versus 1.5 (P = 0.0002).
  • FACT-G score = 64 versus 96.3 (P = 0.0001).
  • FACIT-F score = 24 versus 46 (P = 0.0003).

Dr Arun Rajagopal's team concluded, "Survivors of cancer who chronically consumed opioids experienced symptomatic hypogonadism with significantly higher levels of depression, fatigue, and sexual dysfunction".

"With the increasing use of opioids among patients with cancer, further research in improving quality-of-life outcomes is warranted".

Cancer 2004; 100: 851-8
18 February 2004

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