Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy.

Abstract Objective To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. Materials and methods 120 patients with localized prostate cancer were enrolled. Ninety-two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. Results Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p p p p 0.039; free testosterone 5.94 vs. 7.5 pg/ml, p 0.018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21.01 vs. 8.51 U/l, p p 0.03). Conclusions Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ.