PSA and Testosterone

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Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/7/2011 11:52 AM (GMT -6)   

 I would like some opinions. All of these websites deal with Prostate cancer and testosterone. OK. I posted some of these websites before but lost track of it. Anyway, I am tired of being tired, and disinterested, unhappy, moody, etc. These studies in the websites indicate that testosterone replacement therapy does not increase the reoccurrence or growth in cancer cells. I have printed these out and tried to get my doctors to read them with no luck. Am I asking for too much or are my doctors being too wary at the expense of my quality of life?

http://www.canada.com/mont%20realgazette/story.html?id=8537898f-c98d-4dde-9d70-12dc0b6dcd41

https://www.bcm.edu/news/item.cfm?newsid=892

http://www.lef.org/magazine/mag2008/dec2008_Destroying-the-Myth-about-Testosterone-Replacement-Prostate-Cancer_01.htm

http://articles.latimes.com/2009/mar/30/health/he-testosterone30

http://www.webmd.com/prostate-cancer/news/20061114/testosterone-may-be-safe-for-prostate

http://www.griffinmedical.com/Testosterone_Prostate_Cancer_Studies.htm

http://www.news-medical.net/news/20110420/Testosterone-therapy-for-prostate-cancer-needs-reevaluation-New-study.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2312346/

http://www.renalandurologynews.com/relationships-of-testosterone-and-prostate-cancer-a-2011-perspective/article/202104/

http://www.prostate-cancer.org/pcricms/node/311?id=18527

http://www.endocrine-abstracts.org/ea/0022/ea0022p544.htm

 


Age: 52
PSA: 4+ - 12/2009
4+ - 1/2010
4.6 - 3/10/2010

biopsy 3/25/2010
Gleason: 3/31/2010
RB 3+3, RM 4+3, RLM 3+3, RA 3+3

Divinci Surgery: 5/26/2010
Nerves spared

Post PSA: 0.01 7/9/2010

Adjuvant Radiation Therapy ~ IMRT, plus Hormone Therapy (1 only Lupron 7.5)
39 scheduled, started 7/26/2010 Finished 10/4/10

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3176
   Posted 6/7/2011 3:22 PM (GMT -6)   
that's alot of stuff to read   cool .
 
ed
 
 
 
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 285
   Posted 6/7/2011 3:35 PM (GMT -6)   
I am with you on this one. I am tired of feeling tired, disinterested, depressed. In my case my surgeon has always said he would give me T if i wanted it since i had a gleason 6 tumor with clean pathology, psas all undetectable since surgery. I can get great erections with trimix but never orgasm with wife anymore because my interest is gone. My T level is 230, should be at least 500 for man my age. I am scheduled for my yearly psa next February. Im still on the fence about asking for T, heavens knows I dont want this cancer to come back after reading all the posts here of everybody's struggles. Intellectually I know the odds of it happening are low, but both of my parents died of breast/colon cancer, something in me still doesnt want to take a chance on this.
My age= 52 when this all happened.
DRE=negative,
PSA went from 1.9 to 2.85 in one year, biopsy ordered,
Second biopsy on 08/14/08 found 2/12 cores positive for CA on R side, 1 core=5%CA, other core=25% CA, Gleason score= 6 both cores,
Bilateral nerve sparing robotic surgery on 09/11/08, pathological stage T2A,
No signs of spread, organ confined,
6 0's in a row, still use trimix for ED

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1722
   Posted 6/7/2011 4:54 PM (GMT -6)   
MSPT98...I'd find a new Physician. Your stats are better than Paul's and he's just celebrated his 6 year PSA of <.1, with a weekly shot of testosterone. Our approach was to tell the Uro, Paul would do the shots with or without his support but, we'd rather have him on the same team. He's been of great help:>)

Fallcrop....Your team is going to need more time before they agree testosterone.
Surgery alone was not successful. Less than a year later may not be enough of a cushion between treatment and a series of clean PSA's. Perhaps discuss a time and goal when it may be possible, rather than asking for T now. The other alternative is to find a sympathetic Physician who is willing to try things your way. I don't think anyone can question that you believe quality of life is worth taking an amount of risk.


Gppd luck to you both
Swimom
A life moving forward is never passed by.

reachout
Veteran Member


Date Joined May 2009
Total Posts : 582
   Posted 6/7/2011 5:05 PM (GMT -6)   
Fallcrop, a different question, why did you have adjuvant with a Gleason of 3+3 and a post-surgery PSA of just 0.01? Am I missing something?

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/7/2011 10:08 PM (GMT -6)   
I'll do this in the order posted.
mspt98 - Haven't tried the Trimix yet but don't really see a need since I am like you and have a lack of interest. Wasn't that way very often before all this. I don't want the cancer back either but after researching the internet (some links on original post) I'm not that nervous about doing testosterone replacement therapy. I am impressed with the studies from Harvard, Baylor, California, etc. contradicting the original study from 60 years ago. My Oncologist and Urilogist say I read/research too much on the internet, I think they need to do more of it. I have to live with this and its effects the rest of my life. Sorry, didn't mean to get on my soap box.
 
Swimom - Waiting for a couple of years or more seems to be the norm but the newer studies are disproving the old school of thought that testosterone feeds cancer cells. Also it is hard to argue the logic one doctor pointed out; If testosterone caused prostate cancer why would you not have it between the ages of 18-22 years old when testosterone levels are at their highest? And why would almost all prostate cancer develop in men when their testosterone levels have dropped off to low levels?
 
Reachout - you are not the first one to ask this. I really don't know. I was just following the advice of my doctors when this was all new to me. I had originally said no but my Oncologist and Urilogist both insisted that I needed to. They both said that mine was fast growing and aggressive, and that any remnant cancer cells could grow quickly again.
 
Thanks everyone for their input. I am hard headed but I do value your opinions.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1722
   Posted 6/7/2011 10:19 PM (GMT -6)   
Fallcrop,

I was not suggesting anything other than the protocols haven't changed and you did have advanced treatment, not early stage. Doc's are going to go one of two ways....agressive or as the patient wishes. Good luck.
I hope you do find what you need because it is such a quality of life issue.

Swim
A life moving forward is never passed by.

biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1455
   Posted 6/7/2011 11:17 PM (GMT -6)   
There are a few of us that are on testosterone replacement therapy after prostatectomy. I was on testosterone shots for years before PCa   My original uro/sugeon was dead set against it and made me go off T cold turkey.  My life immediately went down the tube.  No energy, no sex drive and severe depresion.  I was at the end of my rope.
 
I saw some postings here on HW between Swimom and another PCa guy with low T and knew that I didn't have to live like that.  After several fruitless conversations with my uro, I found another uro that went along with replacement therapy.  I've been with him since 2007 and have had zero psa's since then.  I know I would not be here today if I hadn't found this forum and got to talk to Swim.
 
Jim
Age 76. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06. Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + .05 cc Trimix = Excellent Results
PSAs from 1/3/07 - 8/02/2010 zero.
Next PSA - July/2011
Lung cancer dxed 6/08. Surgery followed by chemo. In remission since.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2269
   Posted 6/8/2011 10:03 AM (GMT -6)   
4+3=7, not 6.....Four being the primary number, You must have had positive margins too to be given adjutant RT/HT, right?
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/8/2011 11:46 AM (GMT -6)   
Swimom - I think I must owe you an apology. I guess I have gone on the defensive after my doctors turning deaf ears on me. I am like biker90, no energy and sex drive which bothers me. But the depression sometimes is what scares me. I have already gone on a med for temper flares, which has helped that situation. After reading all the effects of lowT, I think it would help all my symptoms. But again, my apologies to you. You and the others are the reason I come to this forum, the sincere efforts of the members to offer help and encouragement to each other.

Fairwind - You are right.
Age: 52
PSA: 4+ - 12/2009
4+ - 1/2010
4.6 - 3/10/2010

biopsy 3/25/2010
Gleason: 3/31/2010
RB 3+3, RM 4+3, RLM 3+3, RA 3+3

Divinci Surgery: 5/26/2010
Nerves spared

Post PSA: 0.01 7/9/2010

Adjuvant Radiation Therapy ~ IMRT, plus Hormone Therapy (1 only Lupron 7.5)
39 scheduled, started 7/26/2010 Finished 10/4/10

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 705
   Posted 6/8/2011 2:10 PM (GMT -6)   
Fallcrop,
You seem to be under the impression that testosterone doesn't promote prostate cancer growth from the links cited. Those links relate to testosterone not causing prostate cancer which is a very different thing.

Once a person has cancer and is treated, there is always the possibility that dormant cells remain. The risk of supplementing with testosterone after an advanced disease diagnosis and treatment has a higher risk. I am not saying that supplementation is not possible in such cases, but it requires that those involved understand what they are doing to avoid triggering unwanted progression.

Rather than supplement with testosterone, why not try resistance exercise and see if that helps your natural testosterone production. Understand that supplementing testosterone will reduce your natural testosterone production and if prolonged, induce testicular atrophy. Not a good thing and a long commitment. On the other hand resistant exercise might help naturally. See:
tinyurl.com/4yxeo6t

RalphV

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1722
   Posted 6/8/2011 6:00 PM (GMT -6)   
NO prob Fallcrop...tis a difficult experience, this hypogonadal thing! Paul was much younger than you and believe me, if his Doc's had not agreed, he'd still be taking it because his life was not of any quality without testosterone. The alternative for Paul was worse than the risk of recurrence. Do what you need to do and keep us up to date.

Swim
A life moving forward is never passed by.

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/8/2011 10:01 PM (GMT -6)   
 Just wanted to show some excerpts from the links I posted at the beginning of this thread.

An increasing number of newly diagnosed men with prostate cancer opting for active surveillance, and with many of them also desiring treatment for their signs and symptoms of testosterone deficiency, the results suggest a reevaluation of the long standing prohibition against offering testosterone therapy to men with prostate cancer," says Morgentaler, MD, Division of Urology in the BIDMC Department of Surgery and an associate clinic professor of surgery at Harvard Medical School

The first study addressed the loss of libido, energy and erectile function, all symptoms of hypogonadism, inadequate functioning of the testes, after prostate cancer surgery. The results suggest significant improvement in symptoms after the initiation of testosterone replacement therapy. Dr. Larry Lipshultz, Baylor College of Medicine

Recent reports have trickled out to show that men who have undergone radical prostatectomy for localized prostate cancer and have an unmeasurable PSA can be safely treated with exogenous testosterone as long as the PSAs are carefully monitored. Jacob Rajfer, MD Department of Urology, University of California at Los Angeles, Los Angeles, CA

In the 70 years since its identification as a PCa growth promoter, testosterone has become inextricably associated with this disease. The paradigm of limiting the use of testosterone in patients at risk for or after treatment of PCa is changing. The authors believe that with proper informed consent, testosterone may be offered to patients treated for PCa with the understanding that only small, non-randomized studies with short follow-up have shown no worse outcomes. Kelly Chiles, MD is a resident in the Division of Urology at the University of Connecticut Health Center in Farmington, where Stanton Honig, MD, is Associate Clinical Professor of Surgery. Dr. Honig also practices at the Urology Center in New Haven, Conn. and is a member of the Renal & Urology News editorial advisory board.

A literature review was undertaken exploring testosterone replacement therapy following treatment for prostate cancer, and concluded that testosterone therapy can be considered after radical treatment of prostate cancer by prostatectomy.

Rachel Smith, N Karavitaki & John Wass  Department of Endocrinology, OCDEM, Churchill Hospital, Oxford, UK.



Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1722
   Posted 6/8/2011 10:04 PM (GMT -6)   
OhioState,

I am actually in agreement with anyone puts quality of life in the forefront whenever that is his/her well thought out decision. Paul was in his 30's when his T dropped to miserable levels and we listened to all the wrong advise for a decade. I remember the Uro telling us that testosterone injections would cause PCa. Well, guess what? Paul took that scare tactic seriously and lived a miserable life for a decade only to develop PCa anyway! In fact, it was the quality of life issue that finally got him to start using testosterone. Within a month or two that pesky PSA jumped giving an early warning that he had PCa. The end result is, he was diagnosed early and now he can use T shots. His life is a lot better than it was. Latest May, 2011 PSA, <.1 at the 6 year mark.

Doc's are protocol driven and litigation leary. They generally do what the protocols say because it is evidence based and generally the safest way to go....assuming it's for patient and themselves. In Paul's case, they happened to be incorrect..or correct....or something!

Swim
A life moving forward is never passed by.

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/9/2011 10:17 PM (GMT -6)   
Just an update to my quest. Turned down by another doctor this morning. Out of frustration I emailed one of the doctors I quoted above. I never really expected to hear anything from him. 30 minutes later he has emailed me back from his phone. He asks me why I don’t come see him. He gives me his office number to call and make an appointment. I call and I am scheduled to see him in a couple of weeks. Its been a good day.
Age: 52
PSA: 4+ - 12/2009
4+ - 1/2010
4.6 - 3/10/2010

biopsy 3/25/2010
Gleason: 3/31/2010
RB 3+3, RM 4+3, RLM 3+3, RA 3+3

Divinci Surgery: 5/26/2010
Nerves spared

Post PSA: 0.01 7/9/2010

Adjuvant Radiation Therapy ~ IMRT, plus Hormone Therapy (1 only Lupron 7.5)
39 scheduled, started 7/26/2010 Finished 10/4/10

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 6/29/2011 3:12 PM (GMT -6)   

Another update. I saw Dr. Lipshultz at Baylor College of Medicine in Houston last week. I was impressed. He seems genuinely interested in his patients and is helping men to regain their Quality of Life through testosterone replacement therapy. Him and other Dr's are proving that this is a safe and effective treatment method after a Radical Prostatectomy. If you haven’t read the links I posted at the beginning of this tread take a little time to go back and read them.

I'm sorry if this sounds like an advertisement but I have to applaud him and the other Dr.s that are doing these kind of studies to move medicine forward and help those of us that have suffered from depression, loss of libido, energy, erectile function, etc. because of our low T levels. 

 

Fallcrop

 


ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 705
   Posted 6/29/2011 4:23 PM (GMT -6)   
Fallcrop,
Can you tell us what Dr. Lipshultz is proposing to do to you to improve your current situation?

Best,

RalphV
Phoenix, Arizona
Disclaimer: I am a long-term prostate cancer survivor. My comments are not intended as medical advice. The intent is to provide information. Seek direct recommendations from your medical team.
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/m

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 7/4/2011 8:58 PM (GMT -6)   

He has put me on Testin 1% to raise my testosterone levels, Pentoxifyllin ER 400mg 3X day, L-Arginine 500mg 1x day, give me some samples of Muse to try, told me to keep taking the Cialis 5mg daily, and keep using the pump 10-15 minutes a day.


Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 7/5/2011 7:24 AM (GMT -6)   
Here is a interesting article on FoxNews.com today about testosterone.

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 705
   Posted 7/5/2011 11:02 AM (GMT -6)   
Fallcrop,
I realize that you do not feel well after your PCa primary and salvage treatment, but from your signature:
Age: 52
PSA: 4+ - 12/2009
4+ - 1/2010
4.6 - 3/10/2010

biopsy 3/25/2010
Gleason: 3/31/2010
RB 3+3, RM 4+3, RLM 3+3, RA 3+3

Divinci Surgery: 5/26/2010
Nerves spared

Post PSA: 0.01 7/9/2010

Adjuvant Radiation Therapy ~ IMRT, plus Hormone Therapy (1 only Lupron 7.5)
39 scheduled, started 7/26/2010 Finished 10/4/10

It is difficult to know your present situation as related to your cancer. What is your current PSA? How often will PSA be checked under the present TRT protocol? What other imaging tests are proposed while under TRT? Is your estradiol level going to be monitored?

Fallcrop, I am just trying to provide information so that the TRT protocol be beneficial and the risk minimal. Wish you the best results.

RalphV
Phoenix, Arizona
DISCLAIMER: I am a prostate cancer survivor since 1992. The views or opinions expressed here are my own and are not endorsed nor supported by any agency or institution. Recommendations SHOULD NOT be construed as professional advice.
DX at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/m

Fallcrop
Regular Member


Date Joined Jul 2010
Total Posts : 21
   Posted 7/5/2011 2:18 PM (GMT -6)   

My last PSA test was still in the undetectable range, which was about a month ago.  The doctor told me to go home and celebrate. My first PSA check at Baylor will be at 6 weeks. I will have to ask after this what my schedule will be. I am not sure what other imaging test will be a part of this treatment. Estradiol is produced as an active metabolic product of testosterone. So as the two are linked I would think that it might be monitored, but I am not sure. This would be a good question for me to ask the doctor.

And thanks for the good wishes.
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