Testosterone deficiency syndrome (TDS) is frequently described in men treated for germ cell cancer with rates quoted between 11 and 38% (Huddart et al 2005). Observational studies show that TDS reduces quality of life and carries cardiovascular, metabolic and bone health risks. At our institute we observed that men with symptoms of TDS and ‘low normal’ testosterone (T) (8.6 – 12 nmol/L) were not reliably recognised.
We collected retrospective data from all germ cell cancer referrals to the Bristol Cancer Institute from 2011 – 2016. We documented age, treatment, at least one random T level within a year of diagnosis (grouped into < 8, 8 – 12 and > 12 nmol/L), details of symptoms and treatment of TDS.
Data was collected on 462 patients (36 excluded with non germ cell diagnoses and 26 excluded due to T never being measured). Median age was 36 years (range 17 – 89) with 85% of patients aged under 50. 58% of men had seminoma, 32% non-seminoma and 10% combined germ cell cancer. 41% of all patients had a T level < 12 nmol/L at first measurement (32% of 20 – 29 year olds, 42% of 30 – 49 and 58% of 50 – 59 year olds) and 16% had T
In this retrospective series 41% of patients had at least one total T value
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All authors have declared no conflicts of interest.