approximately 8 nmol/l (231 ng/dl).

Indeed, pre-

clinical evidence even suggests benefcial eFFects oF

higher androgen concentrations on CaP in vitro,

resulting in growth inhibition.

The current study has several limitations. 1) Our

cohort was a relatively small, retrospective sample

without a eugonadal comparison group, limiting the

generalizability oF our fndings. 2) To our knowledge

the eFFects oF TTh on CaP recurrence beyond 3 years

are unknown and we continue to Follow this cohort

to determine these eFFects. 3) The absence oF a

validated questionnaire on symptom improvement

limited our ability to capture the spectrum oF the

clinical benefts oF TTh. 4) While all patients

received RT, the Form oF RT varied among patients,

introducing heterogeneity. Although we report a

small but statistically signifcant diFFerence in PSA

between men who received RT only and those who

received RT and ADT, this was not supported by a

diFFerence in PSA velocity. It may re±ect the limited

sample size and the large SD in these subgroups.

Despite the data presented in the current and

previous studies the lack oF a prospective controlled

trial oF TTh in the setting oF CaP limits our ability to

declare that TTh is saFe in this population. Patient

selection should be diligent and limited to men with

quality oF liFe impairment who are at risk For the

sequelae oF untreated hypogonadism. ²urther, it is

necessary to perForm vigilant monitoring during

treatment in these men until more defnitive saFety

data are accumulated. Nonetheless, our fndings

suggest that TTh is eFFective and potentially saFe in

hypogonadal men aFter RT regardless oF primary

tumor grade. In conclusion, TTH Following RT For

CaP resulted in a minimal mean increase in serum

PSA and a low BCR rate.

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