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Old 12-02-2009, 03:52 PM   #1
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Testosterone Replacement Therapy for Prostate Cancer Survivors

No kidding!

Most of us know that preventing the production and use of testosterone is a key strategy for treating prostate cancer, especially advanced or recurring prostate cancer. So it might strike some of us as nonsensical to actually prescribe testosterone for prostate cancer patients. Yet that is what Dr. Leibowitz and others have done, and they have actually had their work published in a prestigious journal, BJU International, formerly known as the British Journal of Urology International.

First of all, why would anyone WANT to give testosterone to prostate cancer patients? Well, there's actually a very good reason: extremely low or even just abnormally low testosterone leads to a handful or two of adverse consequences: a likelihood of decreased bone density, a likelihood of decreased strength, a likelihood of decreased libido and erectile function, hot flashes, a possibility of anemia, an increased chance of cardiovascular problems (such as poorer cholesterol findings) and diabetes or insulin resistance, and an increased risk of anemia, to name some of the more important issues. Increasing the testosterone level tends to counteract all of these.

Obviously this is the reverse of using expensive drugs to lower testosterone, the therapy I and many others are now on to control our prostate cancer. But other men, such as those who have had surgery but have low testosterone and its consequences, or men who are now in the off-therapy phase of intermittent hormonal blockade, might possibly benefit. That's what Dr. Leibowitz and the five-author group looked at. I also recognize the name of Dr. Steven Tucker, MD, Dr. Leibowitz's former partner, and Dr. Nick Vogelzang, a very well known prostate cancer physician-researcher in the Arizona/Nevada area.

[deleted]

Is anyone on the board with prostate cancer using TRT?

Jim [/COLOR]

Last edited by Mod-S4; 09-24-2012 at 09:45 PM. Reason: Please do not post text from other sources. Thanks.

 
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Old 03-07-2011, 10:59 AM   #2
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Wink Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

This is a great thread! I had radical prostatectomy surgery roughly eighteen months ago (my age = 67). About four months after the surgery my PSA was 12. My urologist suggested Lupron as the course of action. The little I knew at that time was that taking Lupron was essentially chemical castration. For the last 15 years I have had very low testosterone (T) test scores. (I may be an expert in the area of low T Some of my symptoms were:

1. Diminished libido.
2. Impaired erectile function.
3. Male boobs
4. Decreased muscle mass and increased fat-to-lean tissue ratios.
5. Diminished energy level and sense of well-being.
6. Depression and fatigue
7. osteoporsis (I didn't have this but it is another serious risk factor)

I did some research on the subject of T and TRT and found that:
a. Reducing T down to the castration level does indeed slow the progression of PC
b. The slow progression is not long lasting (1-2 years?) not sure about time
c. High T levels do not cause PC nor does it speed the progression of PC

Below is an excerpt from a Tower Urology Newsletter:
"a literature review of the relationship between testosterone and prostate cancer between 1985 and 2004 demonstrated no compelling evidence that higher levels of serum testosterone, either by endogenous sources, or by testosterone replacement therapy, increased the risk of prostate cancer or caused prostate cancer progression."

Dr. Morgentaler discusses PC and TRT in great detail (Chapter 7 in his book "Testosterone for Life" is very interesting).
The referenced study from BWhitney supports Dr. Morgentaler's paradox discussion. If the PC patient is starting the TRT treatment with a low T then the benefits of a near castration level of T is negated, thus causing a rise in PSA.

My concern: Most urologists and oncologists are not clearly presenting all of the options and side effects to the patient (The PC threads are nearly all about chemical castration and not about alternative treatments). If a patient is confronted with all of the very negative side effects of chemical castration and the fact that this treatment is only a temporary solution the patient might elect to try other treatments. If the patient has low T they might even elect to go with TRT. It has been my experience that TRT has greatly enhanced my quality of life -- my energy level increase is very noticeable. I do a lot of gardening -- many of the college kids can't keep up with me.
If given a choice between living 10 years under chemical castration or 7 years of TRT -- I'd choose the TRT with high energy and libido. Quality of life is higher on my list than longevity. I don't want this to sound argumentative -- everyone has different priorities

 
Old 03-07-2011, 11:22 AM   #3
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Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

Just a quick follow up from 04chris. It has been about 18 months since my surgery. My PSA spiked at 25 about six months after surgery and has been declining ever since -- it's now at 8. (I realize that until the PSA gets near zero there are still a bunch of PC cells floating around but at least my PSA is heading in the right direction. I should be getting a bone scan shortly. Not sure how to test for PC in the lymph nodes?


I use a lot of Henderson and Dr. Blaylock's recommendations

My primary alternative supplements are:

- High ellagic acid (70%) Pomegranite powder (2 tablespoons in a smoothie -- yuk). It's made from the rind.

- Dr. Budwig's diet (6 time nominee for Noble) -- 5 tablespoons of Flax seed oil plus 5 tsp methionine (I use methionine instead of the cottage cheese recommended by Dr. Budwig. Methionine is the sulferated protien found in cottage cheese and makes the Flax Oil water soluble)
All of the above goes into my smoothie
Pill supplements:
- curcumin
- green tea extract
- beta glucan
- Vitamin D3 (10,000 IU)
- Artemisinin
- Lycopene
- Vitamin K2
- Doxycycline (reduces PC metastasis into the bones -- anyone else trying this? Studies have shown that this works)
- Lactoferrin
- DIM (reduces conversion of T into estrogen)

The down side of using alternative supplements is the cost -- nothing is covered by insurance. I'm spending around $400 per month using this shotgun approach.

Last edited by 04chris; 03-07-2011 at 04:55 PM.

 
Old 02-28-2012, 08:15 AM   #4
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Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

Has there been any follow up on the users since 2007? I am considering now and my Doctor wants me to sign a release concerning the risk?

 
Old 07-05-2012, 09:40 AM   #5
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Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

Quote:
Originally Posted by smstone View Post
Has there been any follow up on the users since 2007? I am considering now and my Doctor wants me to sign a release concerning the risk?
SMSTONE,

Yes, I am a prostate cancer survivor and am on TRT. I had a radical prostatectomy in July 2009. No chemo needed. Surgeon confident he got it all, and PSA has been undetectable since (three years!) Prior to discovery of my cancer, I had been on TRT (Androgel) for a bout 6 months for low T - which was a noticeable and appreciated boost to my sense of well being, motivation and libido). My urologist/surgeon began TRT a year after my surgery, with 2.5mg of Androgel 1% daily. But not much relief to low libido. Over time, dosage was increased. Had sampled Axiron (applied under armpits - messy, drippy), then went to Adrogel 1.62% pump. Over time, worked up to 4 pumps/day (max dose) as my T level remained below normal range. I never really felt that this was helping - no libido, and bloodwork for T was sporadically up or down, but mostly below normal levels. (one was 61). Last week, I saw my Internist, and discussed that skin absorption TRT was not working for me. She prescribed 1/2cc Depo (100mg) weekly, and showed my wife how to inject. This was Monday. Well, Monday night I felt better than I had in a long time, details withheld. But... not since. Just the same old blah. Getting blood work done in 2 more weeks to follow up. Will also ask about testing for estrogen. Reading these boards for info on all this. I am NOT a body builder; just a regular guy. 5'11, 180, 52 years old, and otherwise healthy. Of course I am watching my PSA every 4 months. My surgeon is nationally known, and famous for pioneering and teaching other doctors on the DaVinci robotic surgery method. I have great confidence in him. If my T level does not make it (well) into the normal range in three weeks, I'll see if my Internist will increase my dosage. Good luck to you!

 
Old 07-05-2012, 10:14 AM   #6
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Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

For some reason, we seem to notice the change in testosterone levels and acclimate quickly to the higher stable level. I remember the immediate effect on my libido when I took it a number of years ago, and that it was not sustained in spite of sufficient serum levels.

Libido, and that sense of well being, is a product of a number of factors of which T is just one. Some dopamine agonists have helped for some men. These may include pramipexole, apomorphine or cabergoline.

After I took T to help with a sports injury, my doctor gave me shots of HCG to re-start my natural production of T. Because of negative feedback, your body stops producing its own while you're taking it externally. Vacations and/or HCG shots may sometimes bring it back.

- Allen

 
Old 07-05-2012, 10:26 AM   #7
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Re: Testosterone Replacement Therapy for Prostate Cancer Survivors

Thanks, Tall. Yah, I'm not sure what else I'm missing. My Internist did a full blood workup, and everything else looks fine (did not do estrogen, though). I have started working out again, after a year or so of not doing much. Just light cardio, crunches and pushups so far. My wife cautions to be patient; that after the second or third shot, I may start feeling better. I'll wait...

 
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