Identified as sarcopenic on latest computerised tomography (CT) scan prior to intervention (part of initial investigations - using Martin et al (2013) criteria - 43cm2/m2 for Body Mass Index (BMI) \<25, 53cm2/m2 for BMI\>25)
Documented low or normal testosterone at time of recruitment (\<12 nano moles/ Litre (nmol/L)
Eligible for operative intervention
Capacity to consent
Able to mobilise \& able to complete the 6 Minute Walk Test (MWT)
Post completion of chemotherapy/ chemoradiotherapy treatment (if the patient has neoadjuvant treatment)
Booked straight for surgery with an interim of 4-8 weeks.
Participation in another concurrent trial/ study is accepted, following discussion between the two trial /study teams
You may not be if
Not sarcopenic on computerised tomography (CT)
History of Deep Vein Thrombosis (DVT)/ Pulmonary Embolism (PE)/ prostate cancer/ breast cancer
Prostate nodule identified during digital rectal examination (DRE) or magnetic resonance imaging (MRI) pelvis
Multiple distant metastasis which are non-operable
Prostate specific antigen (PSA) \> 3 nanogram/ mililitre (ng/ml)
Haematocrit (HCT) \>52%
Severe lower urinary tract symptoms
Class III/ IV heart failure
Myocardial Infarct or stroke within the last 6 months
Dementia / No capacity to consent
Patient on medications with anti-androgen effect eg spironolactone
Patients with untreated severe obstructive sleep apnoea
Morbid obesity as defined by Body Mass Index (BMI) \>40
Uncontrolled hypertension
Patients on long term steroids during the trial period
Patient on other anabolic agents
Not already on treatment for primary hypogonadism
Patients with bone metastasis
Clareo Health | Perioperative Testosterone Replacement Therapy in Sarcopenic Male Colorectal Cancer Patients
