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Testosterone Replacement Therapy

DerekO
Posts: 6
Joined: Feb 2010

Hi everyone. I would like to thank all of you who have supported me without your knowledge. I have been a member since Jan of 2010 but for one short post have not contributed since. Though I have read your posts on a weekly basis. Thank you for your courageous sharing and the depth and breadth of your knowledge. I had a RP at Sloan Kettering which resulted in a positive prognosis,clear margins and organ confined. My gleason was downgraded to a 3 + 3. Original biopsy was a 4 + 3 with a psa score of just under 9. My local urolgist, a follower of Dr. Morgantellar, had me on avordart in early 2009. In the fall, he put me on testosterone replacement therapy but stopped when my psa spiked indicating the beast awakening. Biopsy confirmed the psa diagnosis. After surgery psa scores showed 0's as have subsequent tests. In April,one year post surgery, he suggests a resumpition of testosterone replacement therapy,as a way to spike my libido and increase muscle mass. I am aware of the debate linking testostone to PC; likening it to putting gasoline on a fire to put it out. That causation factor seems to be supported by flimsy data. My query is, has anyone gone on TRT? Are they still on it and has thier psa levels remained O?

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Hi DerekO

I have not been on Testosterone Replacement Therapy (TRT) and probably would only do it under the vigilance of a specialized oncologist in PCa. There is an article named “Destroying the Myth About Testosterone Replacement and Prostate Cancer” written by Dr. Abraham Morgentaler. You can read it at this site;
http://www.lef.org/magazine/mag2008/dec2008_Destroying-the-Myth-about-Testosterone-Replacement-Prostate-Cancer_01.htm

However, as you know preventing the production of testosterone is a key factor in hormonal treatment for treating prostate cancer, especially in advanced cases.
TRT is therefore controversial and many doctors are against the procedure in PCa patients. Nevertheless, the famous oncologist Dr. Leibowitz and his partner have worked on testosterone replacement over ten years, and published his results showing significant improvement on the quality of life of patients without prejudice in terms of cancer control. He has published an abstract in the BJU International (formerly known as the British Journal of Urology International). Here is the site with the full article;
http://compassionateoncology.org/pdfs/TRTBJU.pdf

TRT has by itself negative side effects which should be of concern particularly if patients have other health problems. Here is a list with details;

http://www.andropausespecialist.com/negative-effects.html

I hope you find success in the treatment.
Take care
VGama

DerekO
Posts: 6
Joined: Feb 2010

Thanks Vasco,
I apprectiate the time you took and the threads you mentioned.
I will connect to them later. And I will report back so others can have than info as well. Now I'm about to feast upon a pork loin roast ladden with garlic and fennel seed.
Too bad I can't wine with it but it will still be deliscous.
Take care,
Derek

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Derek, could you share why your testosterone is low? Did you have hormone treatment or is there some other condition that causes low testosterone? Are there other potential factors that could cause a loss of libido other than a low T score? BTW, what is your testosterone level?

K

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Kongo, I hope Derek passes on insights on his case.
The question mark starts at Derek’s treatment with Avodart in 2009. I think that he was put on dutasteride because of suspected BPH, and the drug have given him the typical side effects of 5-ARI as impotence and decreased interest in sex.
TRT is used as a counter measure for ED symptoms (Doctor Abraham Morgentaler is an advocate of that treatment).
There is also a general understanding that low testosterone is a risk for prostate cancer prognosis rather than high testosterone.

His doctor’s next approach to start TRT after surgery is logical for improving testosterone levels which may be causing muscle mass loss (Libido is questionable), and should not be of concern.
In the case of cure after RP, high testosterone levels is not a “spike of fire” in the initiation of prostate cancer (no prostate in place), any more, and in the case of recurrence, testosterone could play a role in earlier progress but not being the cause of cancer “awakening”.
Derek has a good chance to resolve his problem with TRT, and he can stop it if recurrence is seen.

His chronology seems to be this;
2009 (earlier), Avodar
2009 (fall), TRT, Gleason 7, PSA=9
2010 (Apr), RP, Gleason 6, Stage T1 or T2, PSA=0
2011 (Apr), expected TRT

Wishing you both a continuous recovery from treatment.
VGama

DerekO
Posts: 6
Joined: Feb 2010

Thanks for the links, VGama and the questions, Kongo.
I have my uro appt in mid April and I will get my testosterone level history, also my current level as well as my 1 year post surgery psa reading. The links you recommended, VGama, point to the positeve and the negevative thoughts about TRT.
The steroid scandal in baseball got me to thinking at that time about taking steroids to increase my muscle mass. Though I worked out,ran and swam my muscular strentgh seemed to be declining. As I researched testosterone and steroid therapy I read about the medical assumption that this would increase my chances of developing prostate cancer. Well, I didn't want that. But, lo and behold, I got it anyway. My uro, a follower of Dr. Morgentaler, did start me on TRT but took me off when my BPH symptoms turned out to be cancer.
Now that I am 60 and a prostate cancer survivor I want the best quality of life available to me. My thinking about TRT is it will invigorate me ,maybe not in the ways your compatriot, VGama, Ponce de Leon, wanted when searching for the fountain of youth but perhaps,help restore me to the vigor of middle age. Additionally, I think increased muscle mass will make me less prone to the falls older people are prone to which result in debilatating injury. I know I am not that old but I also know, I am not as ballanced as I was when younger.
Now it seems that an indicator of prostate cancer is early onset balding. I started losing my hair in my late teens and my 50 I was sporting the Yul Brynner hair style.
thanks again
updates will folllow.
Derek

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