Aspects of hypogonadism in oncological patients receiving antitumor treatment. Literature review

Recent development of anticancer drug therapy and the improvement of surgical interventions have led to better oncological treatment outcomes for most patients. The introduction of targeted therapy and immuno-oncological agents into clinical practice has allowed previously incurable diseases to be transformed into chronic conditions. While focusing solely on the effectiveness of therapy, many practicing oncologists often pay little attention to another aspect – toxicity. Hypogonadism is a relatively common adverse event (AE) in men undergoing anticancer treatment. The symptoms of this AE (asthenia, erectile dysfunction, mood variability) are often mistaken for complications of drug therapy. Both chemotherapy (CT) and targeted therapy, as well as immunotherapy, can lead to hypogonadism. According to various authors, platinum-based agents can cause the development of hypogonadism in 50 % of cases among young men. Oxaliplatin-containing regimens may result in a decrease in sperm concentration following adjuvant CT for colorectal cancer. Germ cell tumors of the testis, which have high sensitivity to cisplatin-based CT, are among the most treatable malignant neoplasms, even with metastatic processes. The first stage of treatment for germ cell tumors is orchiectomy, which in itself contributes to the development of hypogonadism. Furthermore, when undergoing CT, the risk of this AE increases significantly, up to 50 % in some publications. Considering that this condition affects men of reproductive age with a very high life expectancy, careful monitoring of total testosterone levels is necessary. Uncorrected hypogonadism can lead to various late AEs: obesity, metabolic syndrome, cardiovascular pathology, and osteopenia.This literature review examines various aspects of hypogonadism in men receiving anticancer treatment and its impact on the development of late complications.