Advice Needed

Several years ago, when I was around 40, I started having night sweats and hot flashes during the day. Even if it was a relatively cool day, I would overheat and start sweating like crazy. My family physician checked my testosterone, and it was a little low, so he put me on monthly testosterone shots. That fixed the problem. Now, however, since I've had prostate cancer, my family physician stopped the shots immediately, and now they are back with a vengeance.

Does anyone have any ideas on how to deal with it? I was a G6 with negative margins, would it be safe for me to try and get back on a testosterone supplement? I'm only 45, so I have to look 20+ years down the road.

Charles

I do need to talk to my urologist about this because it's becoming a real quality of life issue for me, but I just wanted to run it by everyone here first. I was hoping someone has an alternative idea on how to deal with this. I should mention, also, that my sex drive is way down since I went off the testosterone shots.

Charles

Hi,I also have low T hormone.My doctor will not even talk about T hormone until you are five years out of surgery.Thanks God it is my eight years of zeros.

In my opinion is it too early for the use of T hormone. 

Charles,
You do not mention your current PSA or your level of testosterone. There is probably not a very high risk to your T supplementation if your PSA is undetectable after surgery for low-risk PCa, although the risk cannot be totally ignored. Good monitoring is essential.

Understand that you need to consult a physician who has expertise in T supplementation as it is a for life commitment and requires keeping track of testosterone's metabolic products to prevent an excess of estradiol and/or DHT that can have a detrimental effects such gynecomastia,

RalphV

Charles,

How low is your testosterone? Have you had it tested? Sometimes it drops after treatment but later returns to baseline levels.

Unfortunately it now seems that naturally low testosterone levels are a risk factor for prostate cancer. You would seem to be a case study for that. Because of this, some doctors believe that T should be supplemented starting at a younger age in hypogonadal men to prevent PC.

There have been a few pilot studies on TRT after RP that look promising. You can show these to your doctor and see if he will let you have it.

Testosterone Replacement Therapy in Patients with Prostate Cancer After Radical Prostatectomy.
LONG-TERM FOLLOW-UP OF THE SAFETY AND EFFICACY OF TESTOSTERONE REPLACEMENT THERAPY FOLLOWING RADICAL PROSTATECTOMY
Testosterone replacement therapy after primary treatment for prostate cancer.
Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy

All,

I don't know my current T level. All I know is that 5 years or so ago, I was a "little" low. Guess I need to have it tested. For those who are asking, my last PSA (at approx. 10 mos. post surgery) was < .01.

Charles

Thanks Tall Allen. Unfortunately, I was a little low beforehand. But I don't know how much. Rebounding might mean I'm still a little low.

Tall Allen, That post is very encouraging to me, although it does seem to be focused on the relative short term (to me).

Devasted, I fully support your personal decision, it's all about the "Quality of Life" facet in my life, I no longer am going for the 'Quantity of Life". Each person has to come to that decision on their own terms. It's your life, your choice. And I respect that, as I would want others to respect my decision.

david in sc

My husband got approval from his radiation oncologist at UCSF and his urologist at university of colorado health science center to take supplemental testosterone after he went through IMRT and high dose rate brachytherapy and completion of two years of ADT. The theory is that the threshold level of testosterone that may affect prostate cancer is very low. Testosterone levels above that threshold do not further increase risk. My husband is 69. Dx 4 years ago with Gleason 10 T3a no mets PSA 17. His PSA stayed undetectable while on ADT. It has been gradually rising as expected after going off ADT but is still below 2 which would be considered biochemical failure. He has enjoyed the benefits of a T level, which has remained in normal range despite deciding on his own to stop supplemental testosterone.