If T, pre or post cancer, cannot cause cancer, then why are we lowering the levels of T?
Can T cause cancer?: If T, pre or post... - Advanced Prostate...
Can T cause cancer?
Written by
arete1105
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31 Replies
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Hello Arete, It turns out that testosterone must be present for your prostate cell to sub-divide and make more cells. If take away testosterone the cells do not sub-divide and this is also true for cancerous cells. So if you have been diagnosed with prostate cancer (PCa) there are drugs that lower your androgens.
Then it would seem that if T causes the prostate cell to sub-divide, then men in their 20-30's would large prostates from all the sub-dividing. But that is not the case. Prostate enlargement is occurring with men is later years with lower levels of T.
But how do you answer the link showing T had very little to do with cancer cells. I have a book with 69 studies showing that T has no bearing on cancer cells. Some of those studies even show giving T to men who have had cancer treatment didn't affect their PSA or cancer.
Normal prostate cells are genetically programmed to control their growth ... stop and start (normal genes). The cancels genes don’t “know” when to turn off the growth throug division, or are “striving” to survive through uncontrolled division.
It's called "saturation theory." Think of your cancer cells as a sponge and testosterone as water. Once your cancer is soaking "wet," it can't get any wetter no matter how much T you add. But it CAN get dryer - remove ALL testosterone from the cancer and much of the cancer dies. That's why testosterone must be reduced to castration levels to help with prostate cancer. Healthy prostate cells require testosterone to stay healthy - hypogonadal men (men with low testosterone) are more likely to be diagnosed with prostate cancer than eugonadal men (men with normal testosterone).
TA- the Saturation Theory(ST) is interesting. Let me paraphrase when you said.
The ST level is considered to be 250 ng dl or 8 nmoll. For men who have cancer, been treated and have T levels above ST, additional T didn't make a difference, while men with T levels below ST, were found to have increased cancer.(K think I have this correct from what you said)
Here is a suggested summary/advise from H Morganthaler and his study on this topic.
1-Given the uncertainty of risks, we recommend limiting treatment with T to those with clear potential for benefits, namely those who are symptomatic.
2-The safest group to offer T therapy consists of men with undetectable PSA 1–2 years following RP for Gleason 6 disease or lower. These men are at low risk for developing PCa recurrence.
3-Somewhat more risky are men following XRT or brachytherapy, since the possibility exists of residual in situ PCa. These men often have low but detectable PSA levels, and PSA concentrations may fluctuate from time to time. If PSA rises, it may well be assumed by patient and healthcare providers that increased T was responsible.
4-The most risky group is men with advanced, recurrent, or metastatic disease. It is to be expected that PSA will rise in these men over time, regardless of whether they receive T therapy. Many will eventually die from PCa. Any evidence for disease progression in the setting of T therapy will be attributed by others to higher T. We strongly caution against the use of T therapy in these populations, except in an investigational setting.
5-Men on active surveillance also represent a high risk group. Published reports indicate that approximately 25%–30% of men on active surveillance protocols will demonstrate disease progression over 3–5 years, even without T therapy. Those prescribing T therapy may be held responsible for disease progression even if this would have occurred without treatment.
6-Men with serum T concentrations below the saturation point (approximately 250 ng dl−1 or 8 nmol l−1) are likely to demonstrate a rise in PSA with T therapy. This occurs because serum PSA in a T-deficient man is falsely depressed. The magnitude of the PSA increase will be greater for men substantially below the saturation point than for men with serum T only slightly below it. PSA will usually stabilize after 3–6 months of T therapy. A continued rise beyond 6 months is worrisome for advancing disease.
Use extreme caution in men currently on ADT, particularly if ADT had been instituted to treat metastatic disease. The likelihood is that whatever initial clinical benefits had accrued from ADT will be reversed with T therapy, with the possibility of even greater disease progression. This is the population that demonstrated a high rate of disease progression, usually within 30 days, in older studies leading to the subsequent prohibition against T therapy in all men with PCa. For men on ADT for minimal or localized disease (e.g. no metastases or nodal disease, low Gleason score), consideration should first be given to a trial off ADT, as this will adequately resolve symptoms of T deficiency in many men without resorting to exogenous T treatments.
7-Patients must be advised that T therapy in men with PCa has not been adequately studied to provide any assurances of safety, and that treatment involves risk of PCa progression or recurrence, and death.
We recommend a signed informed consent from all individuals who wish to undergo T therapy after a diagnosis of PCa, regardless of prior treatment or likelihood of cure.
As with any medical treatment, clinicians must weigh the likely benefits against its risks. Given the troubling symptoms and associated health implications of T deficiency in men, and our new knowledge of the biology of androgens and PCa, this calculus has changed dramatically in recent years. In our practice, we have now treated well over 200 men with T therapy after a variety of PCa treatments, including a substantial number on active surveillance. Our experience is that many of these men are willing to accept the theoretical risks of treatment, and are grateful for the opportunity to live a fuller and happier life. Although it must be emphasized to patients that safety data are lacking, on multiple occasions we have heard the same refrain after T therapy: “Doctor, I’d rather live 3 years feeling this way than 10 years the way I felt before treatment.
Question- look at #6 "This occurs because serum PSA in a T-deficient man is falsely depressed."
This seems strange to me. The goal of the AMA is to lower the PSA below 1, but then also the T must have also been lowered to the same level. Now what does it mean for the PSA to be falsely depressed? Does this mean that you can have these low levels of PSA and T and yet cancer can be at higher levels and on it merry way, all they while I am thinking with low PSA and T my cancer is under control?
Sorry- I didn't read all that. I thought I answered your question clearly. If you have further questions, please ask it succinctly - thanks.
This is an interesting article on PCa which includes long term effects of ADT.
I doubt that many guys with stage 4 prostate cancer are too concerned about the long term effects of ADT. It's the short term problem of not having ADT that concerns me a lot more.
You seem a bit confused.
1. Testosterone does not cause prostate cancer. But it will exacerbate cancer caused by other sources.
2. Removal and depletion of testosterone can cure or ameliorate most, but not all, forms of prostate cancer.
3. If you find a study that contradicts the above, you are not reading it properly.
4. There are some emerging protocols that use high levels of testosterone, with clever timing, to manipulate prostate cancer cells response to testosterone in a manner to help treat prostate cancer. There can't be many places where this is currently available. Most likely it is available only as part of a clinical trial.
5. If you plan on self treating yourself with testosterone, by getting prostate cancer treatment from one doc and testosterone from another, you are engaging in irrational self destructive behavior.
I for one can’t accept the degree of uncertainty,and gamble with my life just to keep my sex life alive.
I don't believe that treating yourself with testosterone will help your sex life.
Arete
I Just checked out the article you cited. It appears to be from a website that targets neurotic men concerned about their virility. I wouldn't place a great deal of reliance in their pitter patter.
The author doesn't even rise to the level of a quack. He is a contract writer:
James Reacher
James has over 15 years experience writing for Men's Health, The Huffington Post, as well as ghost writing over 50 books on health, fitness, and wellness for men
Which article are you referring to?
prostate.net/articles/can-t...
Just look at the advertising that supports the site.
Shoot the messenger and ignore the message. That seems to be what you are doing. Mainly what the author is stating is taken from Henry Morganthaler, MD, Harvard trained urologist and other studies. I find no fault with his reporting, based on the studies he cited. I don't see any of the authors personal opinions in this report. I have a Prostate book that has summarized 68 studies, world wide, credible institutions and doctors, that say the same thing as Dr. Morganthaler. This author just quoted from several of those studies.
LOL,
If it walks like a duck and quacks like a duck, then maybe it's a duck. That website has the flavor of an alt right Russian troll farm site.
Here is the test. Find an oncologist at a major medical center who will both treat your prostate cancer and prescribe you testosterone.
Either you can do that or you can't. If you can please let us know.
In the main I agree with you. I am not getting T therapy. Morganthaler only suggested it for "-The safest group to offer T therapy consists of men with undetectable PSA 1–2 years following RP for Gleason 6 disease or lower. These men are at low risk for developing PCa recurrence."
You are correct- most PCPs will not give T for CAa men. But some will. I am not post Ca, so no T for me.
By the way you are not impugning Henry Morganthaler, MD, Harvard Urologist, are you?
"By the way you are not impugning Henry Morganthaler, MD, Harvard Urologist, are you?"
1. Urologists, a relatively nondemanding specialty, are the second highest paid specialty, I think right after brain surgeons or heart surgeons.
2. The huge level of inappropriate surgery by urologists was the cause of the movement to block most PSA testing in the USA.
3. It appears that many docs are attracted to the urology specialty because it pays like heart and brain surgery, but isn't so demanding.
4. Peddling testosterone to needy men is really really less demanding, and even more profitable. Sort of like peddling breast augmentation to needy women.
5. I purchase my plumbing from a plumber, my lawyering from a lawyer, and my cancer treatment from an oncologist.
6. It is really really stupid for a prostate cancer patient to accept testosterone treatment from anyone other than an oncologist. If you limit yourself to major medical centers, I think you will find they agree with me.
1. The web site couldn't even spell Morgantaler's name right. LOL
Here is Morgantaler's website:
menshealthboston.com/about-...
His practice focuses on neurotic men obsessed with virility, not cancer patients.
Once my ADT treatment was completed, my testosterone returned to normal levels.
If you have prostate cancer, why would you have anyone other than an oncologist treat you with testosterone?
i asked the ''experts'' at Dana Farber to put it into layman's terms for me in the very beginning. T DOES NOT cause cancer until P53 and/or PTEN is aberrated...or, estrogen markers are askew.. who cares? CANCER IS CANCER AND THE MOST IMPORTANT THING IS SURVING UNTIL THE NEXT BEST TREATMENT HITS THE MARKET. if you get 8 years, you're lucky. if you get 18 years, kiss the ground.
Hi what is the range for normal T
264-916 according to Lab Corp
the range for free T is 6.6-18.1, according to Lab Corp.
You can go online and google up about Total and Free and symptoms, etc.
What should t be after ADT THANKS
I believe the goal of ADT is to take your T down to 1. The theory is T feeds cancer, so deprive cancer of T and that will slow down the cancer.
After ADT my testosterone returned to normal levels, as you would expect it to.
Once you cease artificially suppressing it, that is what you would expect.
That was a very interesting article on T levels thank you. I have been suffering more from the treatment than the desease & splitting headaches were the last straw for me & my cosudex saw the bottom of the bin. I mean things like man boobs,fatigue,weight gain etc,etc & there is no proof it is working??
So maybe i will die earlier but before that i now enjoy a good sleep,apetite & a good bonk!
Keep up the good fight fellow sufferers & enjoy as much as possible the quality of life our ONC seem to be ignorant off.
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