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Testosterone Use after surgery

xxchris47
Posts: 8
Joined: Sep 2010

Hello Everyone,

It has been a good while since last posting. Had my prostate surgery in Aug. 2010. Post op--4+3=7 with tertiary pattern 5. My urologist said in our first meeting after surgery--we'll be watching you like a hawk. So, every 3 mos. I have had blood work done. Except for first result which was very low (don't remember exact number) the PSAs have gratefully been 0.00. I am going to be 65 in June 2012 --older guy and with very low testosterone, with very diminished sex drive. So I asked for and my doctor started me on 1% Androgel. This was probably 9-12 months ago. Gratefully my PSAs have been as stated even with testosterone supplement. Does anyone know the latest thinking on this? The latest I read was some docs are prescribing it particularly if post op showed real good reading, which my numbers were only fair. I guess my doc thinks quality of life vs. risk and since PSAs have been good let's cautiously try this supplement. It does help with drive and just more vitality. Older thinking was by giving "T" you were fueling the fire but most updated thinking is questioning this. What say anyone out there with an opinion or latest studies info. Thank you very much with any thoughts.

Chris

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

Chris,

From everything I have read the overwhelming "conventional wisdom" suggests that testosterone replacement therapy for a man diagnosed with prostate cancer is unwise because of the direct link between testosterone and the growth of PCa. I recalled reading something some months ago that suggested that it might not be as risky as some have thought and I found the article which you might wish to peruse.

http://prostatecancerinfolink.net/2009/02/06/testosterone-therapy-for-men-with-prostate-cancer-is-it-good-science-and-good-medicine/

Frankly, after rereading this article I am not persuaded that it is a prudent thing to do but there are some experts who have studied this and believe that it poses no more of an increase in risk than anything else.

Men in our general age group (I am 61) have varying levels of testosterone. Mine is in the normal range at 504 nearly two years out from CyberKnife SBRT treatment in June 2010. It strikes me that if this level is not threatening then having someone who is below the low normal range of 241 ("normal" T range is, I believe, 241 - 800) to take supplements to raise their levels to the mid-normal range shouldn't be dangerous either.

The devil of course is in the details at the molecular level and I haven't a clue as to what additional mechanisms might be going on by artificially adding testosterone and what that process might due to spur the growth of prostate cancer.

If your medical team (which includes your urologist and GP) are all in agreement then perhaps a cautious approach is warranted. In my mind, the most important thing post treatment is quality of life. If you don't have a decent quality of life, what was the point of treatment anyway?

Good luck and I hope you keep us updated.

Best,

K

I think it all comes down to individual choices and quality of life.

xxchris47
Posts: 8
Joined: Sep 2010

Thanks so much for your time. The web page was useful and something I had not seen. This will help me have a more thorough discussion with my urologist.

VascodaGama's picture
VascodaGama
Posts: 1504
Joined: Nov 2010

Chris

I do not think that there are newer ways of seeing TRT with or without prejudice to prostate cancer survivors.
There are no known studies or results to prove either way, just as Kongo puts it; "conventional wisdom".

Your stats however are of a risky case (Gs 7 + tertiary 5) which may lead doctors to negate Androgel.
Oncologists specialized in PCa have wider experience on its use in their patients. They too tend to suggest differently in a case like yours. Dr. Leibowitz is known for his “cocktails” protocols which keep his patients in higher levels of T and PSA. Dr. Myers recommends TRT to low risk patients but does not advice the increase of T in other guys unless if the intent is to avoid health hazards of diabetes and heart complications.
In fact he suggests TRT to patients on long periods of hypogonadism, regardless of the risk factor.

Estrogens patches may be an alternative to TRT. Patients get a relief in terms of old age symptoms and get an improvement in energy levels, improve sleeping patterns, and libido, etc. You may discuss the matter with your doctor and do some researches on the matter.
(http://csn.cancer.org/node/234869#comment-1208174)

Here is your past link for the ones interested in your journey; http://csn.cancer.org/node/200186

Wishing you continuous Zeros and improved quality of life.

VGama

“I wish you the best of luck on this unwanted journey. It is not fun, it is not easy, but, it can be done. You just have to decide the way that is right for you.”
…………..Susiebelle (Sep 2010)

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