Testosterone replacement:There is currently a lack of good-quality data evaluating the safety of androgen in patients with history of prostate cancer, but an RCT is underway to assess this.135Other types of HT:• Data from RCT reported effectiveness of medroxyprogesterone acetate and cyproterone acetate for treatment of VMS in prostate cancer patients on GnRH analogue.125• While megestrol acetate is effective in reducing VMS,136 safety appears variable—most studies report good tolerability and safety, but there are cases reporting rising PSA while on megestrol acetate123,137. This evidence concerns the gene GNRH1 and prostate carcinoma.