Oefelein et al reviewed the levels of testosterone seen in surgically castrated males. This can help guide therapy with hormonal agents in men with prostate cancer. The authors are from Case Western Reserve University in Cleveland.
Testosterone levels associated with surgical castration: < 20 ng/dL.
This is less than older levels of < 50 ng/dL reported, reflecting the greater analytical sensitivity of newer analytic techniques.
The most cost effective method to achieve a low testosterone level is surgical castration.
In a man who refuses surgical castration, initiate therapy with a luteinizing hormone releasing hormone (LH-RH) agonist.
(1) If the total testosterone level is < 20 ng/dL, no additional therapy is required.
(2) If the total testosterone level is > 20 ng/dL, add an anti-androgenic agent.
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