Testosterone injections after prostate surgery

larbabe1

My case is a bit unusual. A number of years ago, I had a pituitary tumor. It was operated on and removed, which left me without a functioning putuitary gland. I have since been on hydrocortisone. I was also given testosterone injections to replace the loss of male hormones. Four years ago I developed prostate cancer, in which I had a radical prostatectomy. The testosterone injections were stopped, and I was given Casodex. Since then, I have been unable nor have I desired to have sex with my wife. She has not complained, but I've read research that testosterone injections can be re-started successfully after a certain period, and could help re-invent our sex lives. I have have just begun the injections (with the warning that there is risk of re-occcuring cancer involved). Nevertheless, I've decided to pursue this avenue. My endocrinologist has suggested that I discuss with my urologist about discontinuing Casodex, because it supposedly conteracts the full effects of the testosterone injections. My urologist has left the decision up to me. What is your advice?

Rakendra

Testosterone

I am not an authority, but I will share my experience.  I was a body builder injecting T for several years before my Prostate cancer was discovered.  Perhaps because of this, my bone cancer was widespead in every part of my skeleton.  That was 40 months ago, and now I am doing fine, but no T.  I did casodex for about a year, and then quit.  I did get an orchiectomy.  I lost 35 pounds of muscle and became very weak.  After a horrible year, I was able to start to rebuild my body, but never anything like when I was using roids.

        Now to cut to the chase.  I read about TRT and wanted to try it to build my body again.  My Uro here in the Philippines said that would be like committing suicide, but here in Davao, the doctors are very uneducated about test.  Even the pharmacies and hospitals do not stock it.   I wanted to compete, so I did some light steroids, using Equipose which does not make T levels rise, it acutally makes them go down, a rare event for T.  After only one month, my Psa rose about two points, so I stopped.

About two year slater, I went to a specialist in Singapore.  Singapore probably has the best medicine in South East Asia. My Psa was 3.4 then, down from the original 300 upon diagnosis.  This doctor advised me that my extensive bone matastases were under control and that I most likely would not have any further problems from the cancer.  So, I asked about TRT.  He replied that risk was involved and that he only gave TRT to patients who were lacking in energy and needed a boost.  This was not my case, as I was training two hours a day and had lots of energy.  I am now 84.  I now beleive that for me TRT is not worth the risk, but I have no sex life in any case.  You can monitor the effects by frequent Psa tests to check for rising.  There are many steroids, and each works in a different way.  The most common used by bodybuilders is Sustanon 250 which is an ester of three different roids.  I do not know which are used for TRT.  Equipose is used to accentuate cuts, but is not authorized for use in humans, although it is widely used.  It is used primarily for horses, and is the only steroid that reduces T levels.  I do not know how it would work in your case.  Bottom line is that TRT has helped many people with prostate cancer; others had had to stop because of rising Psa.  My idea is that the reason to take TRT is if one has very low energy levels of T that are having a very negative effect on quality of life, and not as an aid to sex.  Perhaps discontinuing Casodex would be another suggestion, but, once again, I am not an expert.  So, my advice would be that TRT probably is not worth the chance for you.  You do not mention your age, and this would be a factor.  

        My wife is 29 year old, and getting an orchiectomy was a tough decision for us.  However, it seemed the only avenue open to me to have a life of more than six months, because I refused all other treatment.  Having been a sex addict all of my life, it was a novel experience to have sex drop entirely.  However, the benefits of sex dropping have been great.  My wife and I share much more intamicy now and we are much closer than ever before.  Of course, the basis of our marriage in the beginning was that she was young, beautiful, but very poor, and had to marry for financial security, which is what I brought to the table.  Now, she has exceptional assets and could leave me and be financially independant.  I told her that I would support her in any decision she made, and she is choosing to stay with me.  There is certainly deprivation from giving up sex, but there can also be huge benefits as well.  In other words, there may be a blessing given to you that you have not yet seen.  In any case, be thankful for all that you have been given, and celebrate all the life you have left.  As for me, my Psa is now 1.17 and my life is truly blessed, as we all are.  Best wishes for a new life of discovery for you.  love, Swami Rakendra

VascodaGama

Alive but lacking quality of life

Larbabe

I would like to know more details of your status and treatment. I wonder if you have experienced recurrence.

Are you under Casodex effects since surgery?

What is your PSA histology?

Is there any testosterone test done before?

If the surgery was successful in eliminating the cancer then TRT wouldn't be a worry. However, if after surgery you did not enter into remission (PSA<0.06 ng/ml) then TRT could be a problem. In any case for you to take testosterone shots (your inquire), I would take it as safe depending on how you consider the influence/impact that your castration status has had in the development of your prostate cancer. In other words, either; your cancer is made of cells that do not dependent on androgens to survive, or, with your pituitary out-of-work, therefore without testosterone in circulations, the PCa would have been dependent on the tiny quantities of androgens produced by the adrenal glands and/or by the cancer itself (intratumoral activity), to survive.
The existence of these tiny quantities can be the reason behind your doctor's recommendation in having you on Casodex (?), but you would only confirm it if Casodex has ever shown to influenced the levels of PSA.

A note on the Casodex; this drug works by attaching itself to cells AR (androgen receptors) avoiding absorption of androgens. These occurs at any level so that all cells and systems dependent on the androgens in circulation will not function at 100% rates. Your endocrinologist opinion that Casodex "... supposedly counteracts the full effects of the testosterone injections..." is exactly based on this principle.

I do understand your feelings. Being cured but at the loss of quality living. Radical prostatectomies lead to ED (no proper erections) but the willingness is always there.

Best,

VGama

 

 

Will Doran

Be Careful

Larbabe,

I'd be very careful.  I was diagnosed with at PSA of 69.  Had robotic surgery in Dec 2013, followed by 2 years HT and 8 weeks of radiation.  Testostrerone was knocked down to 17, with normal being 250 - 1,100.  PSA stayed at <0.010 for three years.  Now as my Testosterone has started coming back up, I've had a slight rise in PSA.  Testosterone level was up to 134, 4 months ago, PSA still at <0.010.  Last week new tests show Testosterone up to 320, and PSA has come up to 0.035.  My doctors told me this would probably happen.  I have a 4 month check up on Tuesday (9/6/16), and we will discuss this.  Plans are for either to go back on some chemical treatment (Casodex or whatever else), or if needed to have an orchiectomy.  We have already discussed the options, and treatments if they are needed.  I, like Swami, was/am into heavy exercise.  I have been able to continue all that, except for road cycling for up to 3 hours per day.  I still am on a Spinner Bike for about 100 - 120 minutes per day.  The muscle tone that I lost while on the Lupron, is coming back, as I continue to do my weight lifting and indoor cycling.  In fact at my last set of checkups, the doctors commented that I was getting my muscle definition back.  I've gained a slight bit of weight from gained muscle mass.  However if it comes to that versus the cancer coming back, I'll be doing what is needed to get the cancer back into remission.

My advice is to be very careful and weigh what you really want to have as a quality of life. 

Peace and God Bless

Will

Rakendra

Work out

Hi - I would like to add that Casodex was a nightmare for me.  I took it for one year and managed to have ALL of the negative side effects!!UGH!  Interestingly, my Singapore doc said that with an orchiectomy he would NOT have given me Casodex as well.  I think the orchiectomy saved my life.

   Will, I recommend you to Youtube ron laura matrix.  Click on his pic in the upper left hand corner.  Dr. Laura has degrees from Harvard, Cambridge, and Oxford, all Summa **** Laude.  He is also fluent in twelve languages.  He believes in Meditation and the power of the body to heal itself thru Mindfulness and Meditation (like me).  I have his book Matrix Mindpower which I can send you if you PM me.  He is my fitness guru.  I am doing advanced Matrix up to 76 repetitions per set then, 20 seconds rest and the next set, which he explains on Youtube.  I have tried teaching Matrix here, but no one will do it.  It is just too intense.  The idea is to build the muscle thru mindfullness connecting mind to muscle.  It is NOT the weight that builds the muscle, it is determination and the mind.  It is very successful for me. A competition body can be achieved only by very intense workout and very stricts diet.  There is no free lunch here.  The same is true about healing yourself of cancer.  You had better know about Meditation and mindfulness, positive thought, diet and being grateful for all you have been given.  There is no free lunch here either.  love, swami rakendra

elindsay57

I just had my prostate removed and the doctor said that there was no other cancer. It was caught early. I have lost all muscle mass and feel terrible. He wants me to wait a year before taking testosterone, I don't think I can make it! Will taking test for just 8 weeks hurt? Please help!

VascodaGama

I think you want to go against the advice of your doctor and start taking testosterone. That could be a bad choice.

Accessing "Cure" in prostate cancer treatments has no specific means to certify success in one goal. You need a series of PSA tests to get such status. Meanwhile you have to learn in accepting your newer you.

TRT after prostatectomy is playing roulette, particularly if one has been diagnosed with aggressive Gleason rates.

I would follow the advice of your doctor.

Best wishes for successful remission.

VGama

Old Salt

Did you take testosterone supplements prior to your surgery?