Testosterone supplements

I have had a cancer free psa readings for 5 years. Im getting older and have gained weight ect. I keep on hearing how testosterone can help. Does anyone have any info on the risk of cancer from testosterone supplements ect after a radical prostatectomy and undetected PSAs for 5 years or more considering the link between testosterone and prostate cancer?

thanks mspt98, it doesn't sound like its worth the risk, so many different opinions or interpretaions of the science.
Good luck with your PSA

Paxton said...
In Saturation Theory, they have found that as long as the patient has a T level in the normal range, his PCa will do whatever it will do. Reducing his T level will have NO impact on the cancer until or unless his T level reaches "castrate levels" which is somewhere between 20 and 50 Ng/Mmol.

My summary of the meaning of the paper is that for low to favorable risk PCa patients, for whom ADT would not be standard of care, there is no reason to withhold T supplementation if their T levels fall below the normal range and if they are symptomatic.

If you are symptomatic, I believe it is worth exploring.

If I may ask, what might be the result of TRT supplementation in a hypogonadal very high risk patient who appears to be in remission, whose PSA remains undetectable as long as the testosterone remains at castrate level?

It has been nearly a year since my last Lupron injection, yet my T is still in the teens. And I know that I was already osteopenic before starting Lupron, assuming that I would be considered "symptomatic", though I won't know for sure until after my next round of tests (PSA & T, DEXA) in the next few months.

Just curious, as I've read the saturation studies and remain unsure about what to do if my T never recovers, or if it does and my PSA also rises. Thanks. My doctors have been no help unless I already know specifically what to ask.

You might want to ask your doctors about medications like Fosamax, boniva, prolia which can increase bone density if they feel T is too risky....

RobLee,

Two observations for what they are worth:

First, testosterone is testosterone and it makes no difference to any lingering cancer cells you might have whether it is produced by the testes or smeared on your chest. When your doctors discontinued the Lupron they did so with the expectation that your testosterone would gradually return to normal levels. Allowing your T to rise involved some level of risk that your cancer might recur, which risk was balanced against the ongoing bother of castrate levels of T and the expense and bother of the Lupron shots. Having remained hypogonadial after discontinuing the Lupron the risk involved in supplementation is the same as the risk was for stopping the Lupron. Unless the motivation for stopping the Lupron was that you didn't like the big blunt needles or your insurance didn't like the expense, it follows logically that if the one was worth the risk the other ought to be as well. But, unless your oncologist is from the planet Vulcan with its perfect, dispassionate logic you may find the idea hard to sell.

Second, the passage of time helps, especially for high-risk patients. The longer a high-risk man goes with an undetectable PSA after treatment the better his prognosis gets. High risk disease tends to recur faster if it is going to recur at all. Because you are a higher risk case your risk of a recurrence in the next few years is higher than other guys. But. If you do make it through those few years then your risk is actually lower since if you were going to recur you probably would have already. You may have to give your oncologist some time to warm to the idea of supplementation. It took me almost five years to convince mine.

If, or when, you and your doctors do decide that supplementing your T is appropriate, come back and talk to us about how we get the stuff without going broke. Insurance doesn't like to pay for it sometimes and if you just go down to your local pharmacy with a scrip and say "hook me up" the sticker shock can sting and tingle.

PeterDisAbelard. said...
RobLee, Two observations for what they are worth:

Having remained hypogonadial after discontinuing the Lupron the risk involved in supplementation is the same as the risk was for stopping the Lupron. Unless the motivation for stopping the Lupron was that you didn't like the big blunt needles or your insurance didn't like the expense, it follows logically that if the one was worth the risk the other ought to be as well.

High risk disease tends to recur faster if it is going to recur at all. Because you are a higher risk case your risk of a recurrence in the next few years is higher than other guys. But. If you do make it through those few years then your risk is actually lower since if you were going to recur you probably would have already. You may have to give your oncologist some time to warm to the idea of supplementation. It took me almost five years to convince mine.

If, or when, you and your doctors do decide that supplementing your T is appropriate, come back and talk to us about how we get the stuff without going broke. Insurance doesn't like to pay for it sometimes and if you just go down to your local pharmacy with a scrip and say "hook me up" the sticker shock can sting and tingle.

Thank you Peter, very interesting as well as informative... particularly the high risk aspect. Incidentally, I had noticed on this and other forums that the guys who seemed most likely to experience a recurrence were not the G8 guys but those with PSM... generally "dismissed" by the uro/surgeon as being insignificant. OTOH, those with EPE/SVI tend to go ahead with adjuvant RT with HT and throw everything possible at the PCa, to reduce the likelihood of BCR.

I have no problem with supplementation, and will consider it, if and when it becomes necessary, primarily for the sake of my bones. I suppose TRT is less dangerous than Prolia or bisphosphonates. My periodontal oral surgeon will not treat people who have had them. Lupron has not been a problem financially and the shots are merely uncomfortable. And I I don't mind the brain fog and hot flashes entirely. In fact I've come to enjoy being somewhat of a dumb blonde, free from the drive to excel at everything. As another guy has mentioned of HT, he is at peace for the first time in his life.

Being unsure just how much of the SE's are due to just low T and how much specifically due to the HT, I might even consider orchiectomy if the time to go back on ADT should ever arise. Thanks again for sharing your knowledge on this.