EAU19 Barcelona – 15-19 March 2019 - Testosterone slows PCa recurrence in low-risk patients.

[pjoshea13]

US researchers have found out that testosterone replacement slows the recurrence of prostate cancer in low-risk patients.

One of the largest studies undertaken so far may call into question the general applicability of Nobel-Prize winning hormonal prostate treatment. The work was presented at the European Association of Urology congress in Barcelona.

Doctors have long regarded testosterone as a hormone which promotes prostate cancer. The 1941 work of Huggins and Hodges won Huggins the 1966 Nobel Prize for Medicine, for reporting the dramatic impact of testosterone reduction on prostate cancer. Since then, medicines which reduce levels of the hormone testosterone have become a standard option for many patients.

However, in the late 1990s to 2000s, doctors discovered that although men on long term anti-testosterone treatments were not dying from prostate cancer, they were dying prematurely of cardiovascular disease. It seemed that although anti-testosterone therapies were treating the prostate cancer, the extremely low testosterone levels were significantly worsening metabolic complications such as elevated blood sugar, diabetes, elevated cholesterol, mid-abdomen visceral fat, etc. Low testosterone also caused a loss of sexual function in many men on anti-androgen treatment. This led some doctors to suggest testosterone treatment of some low-risk men after radiation or surgical treatment.

Starting in 2008, a team of doctors from the University of California, Irvine, led by Professor Thomas Ahlering, began to carefully select patients for testosterone replacement after primary treatment of prostate cancer with robotic radical prostatectomy in a bid to improve recovery of sexual function.

The team worked with 834 patients undergoing radical prostatectomy. They treated 152 low-risk patients with no evidence of disease with testosterone replacement therapy. After a median of 3.1 years following surgery, they tested the patients for biochemical recurrence of cancer, as indicated by measurement of the Prostate Specific Antigen (PSA) levels. They found that cancer had recurred in only approximately 5% of treated patients, whereas cancer had recurred in 15 per cent of the patients who did not receive testosterone. Overall, after accounting for differences between the groups, they found nearly a three-fold reduction by three years.

Thomas Ahlering commented "This is not what we set out to prove, so it was a big surprise: not only did testosterone replacement not increase recurrence, but it actually lowered recurrence rates. While the testosterone is not curing cancer per se, it is slowing the growth of cancer, giving an average of an extra 1.5 years before traces of cancer can be found. We already know that testosterone can help with physiological markers such as muscle mass, better cholesterol and triglyceride levels and increased sexual activity, so this seems to be a win-win".

"There have been smaller studies which have hinted that testosterone may not be risky for certain patient groups, but this is the largest such study ever conducted. We're not suggesting that treatment methods be changed just yet, but this puts us at the stage where we need to question the taboo against testosterone use in prostate cancer therapy - especially for low-risk patients after radical prostatectomy. We need the oncology/urology community to begin to review testosterone use," he added.

business-standard.com/artic...

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My feeling is that what they really did was improve the testosterone:estradiol [T:E2] ratio & eliminate estrogen dominance.

-Patrick

[cesanon]

Sartor is talking about straight loads of testosterone as being even more effective than bipolar testosterone treatment for castrate resistant prostate cancer.

[Garp41]

PJ, you've been saying this for close to a decade.

[Shooter1]

Great, too bad I'm extremely high risk instead of low risk. Just wish I was, I'd jump all over that option.

[rfarley01]

Ive been on hormone replacement injections for almost 10 years because I was falling asleep at work and while driving. During this time, my psa varied from 7-32 and back to 18 an the cancer spot changed from 1mm to 8mm before it was laser ablated June 2018. In the 32 an dropping time, and still today, Ive been on daily hemp oil(cbd). 5 months ago, it had decreased to 13.

[Hidden in reply to rfarley01]

So, did the T replacement have a dramatic effect on your sleepiness?

[Adam10 in reply to Hidden]

It did for me. I could go almost all day without deep sleeps every 4-5 hours. It also awoke my sex drive and reduced my ED problems. It increased my sense of well being too. My endocrinologist urged me not to keep missing the injections - I thought (hoped) I could do without them - but he was right. I needed them for quality of life.

[Adam10 in reply to rfarley01]

Hi, Do you find the daily hemp oil more effective, cheaper, or with less side affects? What made you stop the TRT injections please?

I’ve been in Nebido TRT injections for 2 years but stopped while my 10 mm tumor was blasted by HIFU some 4 months ago.

Without the TRT injections, my erectile dysfunction worsened, my sex drive disappeared, and I needed to sleep every 4-5 hours.

I’m investigating if I can restart TRT but am frightened by suspected links to stimulations prostate enlargement and PCa.

Patrick’s post above could be the God send I was looking for.

[Adam10 in reply to rfarley01]

Hi, Glad to hear you had tumor blasted. Will you now be in low risk group? (assuming tumor has been successfully ablated and it does not regrow).

[Adam10]

Great post Patrick thanks. I’m hoping this could greatly improve my quality of life depending if I can restart TRT.

My HIFU Surgeon said a few months back that I could restart TRT subject to PSA test result that I’m taking next week. Will check what group I’m in with urologist next week.

Many thanks again.