Metastatic Prostate Cancer 35 Years After Sex Reassignment Surgery

Abstract

Clinical Practice Points• The exact number of male-to-female transsexuals is not known; however, gender reassignment has become a headline news topic.• Those individuals that have undergone gender reassignment via hormonal and/or surgical means must undergo appropriate cancer screening.• Prostate cancer is the most common non-cutaneous malignancy in men however its appropriate screening guidelines has become controversial.• As the potential of an increased number of male-to-female transsexuals develops, so should guidelines develop for those individuals who have had gender reassignment. Key-words:

Breast and reproductive cancers in the transgender population: a systematic review

“…Case reports . Eight case reports have been published, including a report covering Gooren and Morgentaler's case . The average diagnosis age was 64.8 years.…”

“…Eight case reports have been published, including a report covering Gooren and Morgentaler's case. [37][38][39][40][41][42][43][44] The average diagnosis age was 64.8 years. In all, 62.5% were prostatic adenocarcinomas and 37.5% were unspecified.…”

“…In all, 62.5% were prostatic adenocarcinomas and 37.5% were unspecified. Six transwomen had received hormones for 10-41 years, [39][40][41][42][43][44] and six had undergone gender confirmation surgery including orchiectomy, with the mean age for orchiectomy being 48 years. [37][38][39][40][41][42] Five studies described hormone use after diagnosis, with two transwomen discontinuing 29,44 and three continuing hormone use.…”

“…[37][38][39][40][41][42] Five studies described hormone use after diagnosis, with two transwomen discontinuing 29,44 and three continuing hormone use. [40][41][42] Follow-up data were provided by five studies: three transwomen showed no evidence of recurrence, 39,41,44 recurrence occurred in one transwoman, 43 and one transwoman died of metastatic disease. 42…”

The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?

“…The unique hormonal milieu of a MtFT patient exposed to long‐term estrogen therapy creates a powerful human model to study the effects of estrogen on a developed adult prostate. To date, there have been only a limited number of documented cases of PCa in the MtFT population . It is unclear whether the incidence of PCa is truly lower in the MtFT population possibly due to estrogen therapy and androgen suppression or whether the screening rates are lower in this population, leading to decreased detection.…”