Academic Unit of Clinical Oncology, University of Sheffield, Sheffield, United Kingdom.
Cancer. 2010 Mar 15;116(6):1592-601. doi: 10.1002/cncr.24898.
Androgen deficiency is increasingly recognized in young male cancer survivors; however, its impact on quality of life (QOL) is not established. The authors investigated the relationship between androgen levels, QOL, self-esteem, fatigue, and sexual function in young male cancer survivors compared with control subjects.
A cross-sectional, observational study of 176 male cancer survivors and 213 male controls aged 25 to 45 years was performed. Subjects completed 3 QOL scales (Medical Outcomes Study 36-Item Short-Form Health Survey version 2, the 12-item General Health Questionnaire [GHQ-12], and Aging Male Scale), and measures of self-esteem (Rosenberg Self-Esteem Scale), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and sexual function (Derogatis Interview for Sexual Functioning-II Self-Report-Male).
Cancer survivors had lower scores for all components of the Short-Form Health Survey, Aging Male Scale, and Functional Assessment of Chronic Illness Therapy-Fatigue, and for 4 of 5 subsections of the Derogatis Interview for Sexual Functioning than controls. The majority of these differences remained after adjusting by linear regression analysis. Levels of psychiatric disorder or self-esteem did not differ between the 2 groups. In cancer survivors, those with androgen deficiency (serum testosterone < or = 10 nmol/L) had lower scores than those without for all components of the Short-Form Health Survey, the General Health Questionnaire, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Derogatis Interview for Sexual Functioning. Serum testosterone only weakly correlated with health measures.
Young male cancer survivors self-report a marked impairment in QOL, energy levels, and quality of sexual functioning, and this was exacerbated in those with androgen deficiency. However, psychological distress was not elevated, self-esteem was normal, and sexual relationships were not impaired. The relationship with testosterone is complex, and appears dependent on a threshold level rather than direct correlation. Interventional trials are needed to determine whether testosterone replacement would improve QOL in young male cancer survivors.
雄激素缺乏症在年轻男性癌症幸存者中越来越受到关注，但它对生活质量（QOL）的影响尚未确定。作者研究了雄激素水平与年轻男性癌症幸存者和对照组的生活质量、自尊、疲劳和性功能之间的关系。
对 176 名年龄在 25 至 45 岁的男性癌症幸存者和 213 名男性对照组进行了横断面、观察性研究。受试者完成了 3 项生活质量量表（医疗结局研究 36 项简明健康调查量表第 2 版、12 项一般健康问卷[GHQ-12]和男性衰老量表），以及自尊量表（罗森伯格自尊量表）、疲劳量表（慢性疾病治疗疲劳功能评估）和性功能量表（性性功能障碍 II 自评德罗马蒂访谈）。
癌症幸存者在简明健康调查量表的所有组成部分、男性衰老量表和慢性疾病治疗疲劳功能评估的所有组成部分的得分均低于对照组，在德罗马蒂访谈的 5 个亚部分中的 4 个亚部分的得分也低于对照组。这些差异中的大多数在通过线性回归分析进行调整后仍然存在。两组的精神障碍或自尊水平没有差异。在癌症幸存者中，血清睾酮水平<或=10 nmol/L 的雄激素缺乏症患者在简明健康调查量表、一般健康问卷、慢性疾病治疗疲劳功能评估和性性功能障碍德罗马蒂访谈的所有组成部分的得分均低于无雄激素缺乏症患者。血清睾酮与健康指标的相关性较弱。
年轻男性癌症幸存者自我报告生活质量、精力水平和性功能质量明显受损，而雄激素缺乏症患者的情况更为严重。然而，心理困扰并未增加，自尊正常，性关系未受影响。与睾酮的关系很复杂，似乎依赖于阈值水平而不是直接相关。需要进行干预试验来确定睾酮替代治疗是否会提高年轻男性癌症幸存者的生活质量。
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