I've got more experience with this issue (PCa and testosterone replacement) than I would prefer to have.
Several years ago I was diagnosed with an autoimmune disease that put my pituitary gland out of action. My body produced zero testosterone, growth hormone, and thyroid hormones. And wow, did I go down the drain.
In my late 50s I was an elite senior cyclist, capable of 80-mile daily rides. Then the bottom dropped out. I was deprived of testosterone and growth hormone for the better part of two years. I gained 50 lbs., put away my bike, and went through all the symptoms of chronic fatigue syndrome. At this time my condition was undiagnosed and I put my decline down to getting old.
Those were the most miserable two years of my life. But luckily I found an endocrinologist who correctly diagnosed me and put me on supplements for thyroid, testosterone, and growth hormone. Without exaggeration, I got my life back. Note that my endo was a by-the-book guy: my supplement levels brought me up to normal levels of these hormones for a guy my age, and no more.
Last spring I was diagnosed with prostate cancer (PCa), contained in the gland. At my oncologist's request I stopped my Androgel (testosterone supplement) over the course of brachytherapy (where they insert radioactive seeds into your prostate) and IMRT (radiation from an external machine, which I am undergoing now).
After my brachytherapy my PSA score dropped from 19.70 to 1.51, lower than the average guy who does not have PCa. I expect it to drop further after my course of external radiation.
Recent research has almost unanimously laid to rest that old canard that testosterone supplementation during PCa treatment is like "pouring gasoline on a fire." According to a (now discredited) 1941 study, testosterone "feeds" cancer of the prostate. Medical students have this drummed into them because it has become dogma in the cancer establishment.
More recent studies suggest otherwise. And for me this is good news, because being deprived of normal levels of testosterone (T) comes with its own set of health issues: cardiovascular disease, weight gain, reduced bone density, and more. And beyond those, the patient must deal with depression and hot flashes. And please, no jokes about
hot flashes. They are TERRIBLE. I sympathise with every woman going through menopause and having to endure them.
Alas, my urologist and radiation oncologist, dedicated professionals as they may be, are just too young to have their school-taught prejudices challenged. At their request I am forgoing my hormone supplements during my external radiation phase (which will last through September 2017). And I'll even throw in a couple of weeks after that.
But I know how miserable my life was without T and I don't want to go back. So I won't give up my supplements forever as my docs want. Now that I'm 67, I have too few years left to consign any of them to just existing. Instead, I will patiently explain to my docs that I am willing to risk a recurrence of PCa and regain my quality of life by resuming my hormone supplements, with the understanding I'd be brought back to a NORMAL level of T for a man my age and nothing more.
All the literature tells me that because my PCa has not escaped the gland before treatment, and because I'd elected to undergo both internal and external radiation treatments, with anti-androgen therapy active in both, my odds of PCa recurrence are ridiculously low. And at my age should I experience a recurrence, chances are something else would kill me before the PCa did.
But reading this thread is a reality check. The contributors here, and I thank every one, are obsessed with PSA numbers and this indicates to me that my docs' assurances of a "complete cure" are what newbies like me are too quick to believe and veterans like this thread's contributors know are the stuff of fantasy. I can only conclude that once your immune system is no longer capable of keeping this disease out, you're going to be dealing with it for the rest of your life.
I for one do not want to live my remaining years anxiously awaiting my latest PSA test results. Since being diagnosed in the early spring of this year (2017) I have determined to work with my docs to eradicate the cancer in the most effective way possible, including giving up T supplementation during both internal and external radiation treatment.
But once I'm out of the woods I do not want to look back. I do not want the course of my life dictated by a blood test. Cancerous or not, at 67 my days are numbered. I can only give thanks I have lived this long.
The operative word is "live." I can only speak for myself, but without testosterone I do not find life worth living. I know guys in the same situation who are doing okay without T and I wish them all the best. I wish I was one of them! But I'm not and we need to return to a very basic point: Whose life is it anyway? I have researched this subject extensively and am at peace with my decision: to resume my hormone supplements and let the chips fall where they may. And that means supplementation to normal hormone levels and no more PSA tests.
Because I am a relative newcome to cancer, I do not subscribe to patients setting up their doctors as high priests. We are, all of us, struggling to come to terms with this lousy disease, and if we have learned one thing over the decades stretching back to the Victorian era, it is that the doctors do not have the answers. The least they can do is accommodate the reasonable requests of their patients to enjoy as much quality of life as they can in the time they have left. For me, it's waking up and looking forward to the day. I won't give that up to extend my existence as a drone.
At this stage of my journey, that's the way I see it. I'd be glad to hear from guys who are a little further down the road.
Post Edited (Johntechwriter) : 9/2/2017 10:23:49 PM (GMT-6)