A postulated role of testosterone for prevention of cisplatin gonadal toxicity

Testicular cancer is the most common solid tumor in young men. It has become one of the most curable solid neoplasms by applying multidisciplinary treatment approaches and new chemotherapeutic drugs. Cisplatin based chemotherapy as the most efficient chemotherapy of germ cell tumors has severe deleterious effects on all stages of spermatogenesis by various direct and indirect mechanisms. By marked improvement in oncologic control, prognosis and survival of patients with testicular cancer, their fertility, as one of the essential aspects of quality of life, is a matter of great concern. Since the probability and severity of spermatogenesis impairment is quite unpredictable during a course of cisplatin based chemotherapy, protecting the spermatogenesis during that phase by administration of exogenous testosterone in order to reduce the proliferation rate of germ cells would seem to be beneficial.