Association between megestrol acetate treatment and symptomatic adrenal insufficiency with hypogonadism in male patients with cancer

Authors

  • Rony Dev DO,

    Corresponding author
    1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 008, Houston, TX 77030-4009
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    • Fax: (713) 792-6092

  • Egidio Del Fabbro MD,

    1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Eduardo Bruera MD

    1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Abstract

Patients with advanced cancer may develop cachexia, which is often treated with megestrol acetate (MA). In addition to thromboembolic disease, MA may cause symptomatic suppression of the hypothalamic pituitary adrenal axis. In male patients with cancer, treatment with MA may also suppress the gonadal axis, resulting in symptomatic androgen deficiency. Three cases are presented to highlight the symptomatic burden of adrenal insufficiency and hypogonadism. Clinicians need an increased awareness of the complication of adrenal insufficiency secondary to MA treatment and a low threshold to test for adrenal and gonadal dysfunction in symptomatic male patients with advanced cancer. Cancer 2007. © 2007 American Cancer Society.

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