Hypogonadism in male patients with metastatic cancer prior to chemotherapy.

Gonadal hormonal function was assessed in 44 adult males with disseminated cancer prior to chemotherapeutic treatment of their cancer by determination of plasma testosterone, free testosterone, and luteinizing hormone (LH) levels. Low values for both testosterone (43% decreased) and free testosterone (66% decreased) were seen in this largely malnourished cancer population, in which 82% of patients were less than 90% of ideal body weight. Four patients of serum testosterone and LH were seen: (a) normal testosterone and normal LH (12 cases); (b) normal testosterone and high LH (13 cases), consistent with early primary hypogonadism; (c) low testosterone and high LH (10 cases), consistent with frank primary hypogonadism; (d) low testosterone and normal or low LH (9 cases), consistent with secondary hypogonadism. Significantly decreased ideal body weight was found in the group with low testosterone and low or normal LH level. We conclude that decreased gonadal hormone secretion is frequently seen in adult males with advanced cancer and malnutrition even prior to chemotherapy treatment.