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Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction
Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell dysfunc...
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Formato: | Texto |
Lenguaje: | English |
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Nature Publishing Group
2000
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374403/ https://www.ncbi.nlm.nih.gov/pubmed/10732747 http://dx.doi.org/10.1054/bjoc.1999.1000 |
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author | Howell, S J Radford, J A Smets, E M A Shalet, S M |
author_facet | Howell, S J Radford, J A Smets, E M A Shalet, S M |
author_sort | Howell, S J |
collection | PubMed |
description | Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell dysfunction, defined by a raised luteinizing hormone level in the presence of a low/normal testosterone level. We postulated that mild testosterone deficiency may account for some of the long-term side-effects of treatment, and we have therefore assessed fatigue, mood and sexual function by questionnaire in 36 patients with Leydig cell dysfunction (group 1), and also in a group of 30 patients (group 2) with normal hormone levels who underwent the same treatment for cancer. There was no significant difference in anxiety and depression scores between the two groups although anxiety scores were higher than those previously reported for normal men. Eighty-seven per cent of group 2 were sexually active compared with only 69% of group 1 (P = 0.1), and patients in group 1 engaged less in sexual activity than those in group 2 (mean of 1.8 times per week compared with 3.2 times per week;P = 0.02) Fatigue scores were significantly higher in both groups compared with normal men, but there were no significant differences in any of the fatigue subscales between the two groups. We conclude that mild Leydig cell insufficiency following treatment with cytotoxic chemotherapy ± XRT is not associated with higher levels of fatigue and anxiety but may result in reduced sexual function. These results do not provide a convincing argument that androgen replacement therapy is mandatory to improve quality of life in the majority of these patients, although it may be beneficial in a minority. To establish criteria for selection of patients for a trial of androgen therapy a randomized placebo-controlled study will be necessary. © 2000 Cancer Research Campaign |
format | Text |
id | pubmed-2374403 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2000 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-23744032009-09-10 Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction Howell, S J Radford, J A Smets, E M A Shalet, S M Br J Cancer Regular Article Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell dysfunction, defined by a raised luteinizing hormone level in the presence of a low/normal testosterone level. We postulated that mild testosterone deficiency may account for some of the long-term side-effects of treatment, and we have therefore assessed fatigue, mood and sexual function by questionnaire in 36 patients with Leydig cell dysfunction (group 1), and also in a group of 30 patients (group 2) with normal hormone levels who underwent the same treatment for cancer. There was no significant difference in anxiety and depression scores between the two groups although anxiety scores were higher than those previously reported for normal men. Eighty-seven per cent of group 2 were sexually active compared with only 69% of group 1 (P = 0.1), and patients in group 1 engaged less in sexual activity than those in group 2 (mean of 1.8 times per week compared with 3.2 times per week;P = 0.02) Fatigue scores were significantly higher in both groups compared with normal men, but there were no significant differences in any of the fatigue subscales between the two groups. We conclude that mild Leydig cell insufficiency following treatment with cytotoxic chemotherapy ± XRT is not associated with higher levels of fatigue and anxiety but may result in reduced sexual function. These results do not provide a convincing argument that androgen replacement therapy is mandatory to improve quality of life in the majority of these patients, although it may be beneficial in a minority. To establish criteria for selection of patients for a trial of androgen therapy a randomized placebo-controlled study will be necessary. © 2000 Cancer Research Campaign Nature Publishing Group 2000-02 /pmc/articles/PMC2374403/ /pubmed/10732747 http://dx.doi.org/10.1054/bjoc.1999.1000 Text en Copyright © 2000 Cancer Research Campaign https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Regular Article Howell, S J Radford, J A Smets, E M A Shalet, S M Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title | Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title_full | Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title_fullStr | Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title_full_unstemmed | Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title_short | Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction |
title_sort | fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild leydig cell dysfunction |
topic | Regular Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374403/ https://www.ncbi.nlm.nih.gov/pubmed/10732747 http://dx.doi.org/10.1054/bjoc.1999.1000 |
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