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No single treatment for recurrent prostate cancer is superior in terms of recurrence-free survival, but repeat radiotherapy may be least toxic

There are many treatment options for local recurrence of prostate cancer after primary treatment with radiotherapy; however, there is debate regarding benefits and side effect profiles. This systematic review and meta-analysis of 150 studies of various salvage therapies did not identify a single treatment that was superior in terms of 5-year recurrence-free survival. However, there was some evidence that repeat radiotherapy (in the form of stereotactic body radiotherapy, high dose rate brachytherapy or low dose rate brachytherapy) had lower incidence of gastrointestinal and genitourinary side effects when compared with other treatments. Further prospective study is required.

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Treatment with testosterone does not increase risk of major injury in men or women

Clinicians may be concerned that treatment with testosterone may lead to more violent behaviour and subsequent increased risk of physical injury. A Canadian study conducted a self-matched analysis of individual patients before and after commencing testosterone with respect to frequency of acute traumatic events necessitating emergency care. The study did not find any differences in injury rates following initiation of testosterone …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.