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