Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy -- March 2020

[George71]

bjui-journals.onlinelibrary...

Results:

The median follow‐up was 3.5 years. There were no statistically significant differences in demographics or general health complications between groups. BCR occurred in 11/152 (7.2%) and 53/419 (12.6%) patients in the TRT and control groups, respectively. In adjusted time‐to‐event analysis, TRT was an independent predictor of recurrence‐free survival. After accounting for GGG, pathological stage, preoperative PSA level, and cFT, patients on TRT were ~54% less likely to recur (hazard ratio 0.54, 95% confidence interval 0.292–0.997). In men destined to recur, TRT delayed time to recurrence by an average of 1.5 years.

Conclusion

In our experience, TRT after RP significantly reduced BCR and delayed time to BCR. There was no identifiable general health complications associated with TRT. These findings are hypothesis‐generating and require confirmation with multi‐centered, prospective randomized controlled trials.

[George71]

radical prostatectomy is almost always done without ADT -- which shows that testosterone replacement doesn't increase PCa growth -- in fact it slows it down.

And that is just regular T replacement -- not super physiologic levels of T -- which is showing an even more profound benefit in slowing PCa progression.

It works against all PCA cells -- these are nonCRPC patients ---

I would suspect it would have the same benefit if given immediately after radiation therapy also-- unlike prostatectomy, radiation therapy is often accompanied with ADT ... which may have an even more profound effect in shocking any remaining PCa left behind.

[Jmr11820]

Does RP alone reduce testosterone levels? Routine testosterone therapy after surgery is news to me. My urologist has never mentioned it.

[Hidden]

What’s testosterone?😳

[addicted2cycling in reply to Hidden]

That clear liquid this lucky GL 10 Unique Eunuch gets shot into my upper rump every other week. Sure doesn't make a THANG HARD but does make 100 mile bicycle rides LESS HARD. ;0)

[George71 in reply to addicted2cycling]

Hi addicted2cycling,

I read your bio. great stuff! - I like it - What kind of immunotherapy and how much T do you take weekly and what is your PSA .. If you don't mind.

George71

[addicted2cycling in reply to George71]

Hi G71, one immuno injection of a 3 drug combo in Jan. 2016, sorry but as per doctor's request can not name drugs. Cypionate at 1 ml biweekly results in 1600+ng/dl day after injection between 450/650 before next injection.

[George71 in reply to addicted2cycling]

Thanks addicted2cycling-- I think you are on the right track. My T was naturally around 500 -- last reading was 560.. I just started 2 weeks ago - with 1 ml biweekly also. I have a quarter inch spot in the prostate bed area (SV area) I wonder if it is big enough for the Dr. to do the same procedure on me he did on you?

[George71 in reply to George71]

I need some answers addicted2cycling -- get off that bike and tell me something ! LOL

[j-o-h-n in reply to Hidden]

It's a new Black & Decker Air Fryer "Toaster" Oven with Rotisserie...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/21/2020 6:03 PM DST

[lewicki]

This post is very interesting. I have finished four treatments of LU-177 and AC-225 at the university with excellent results. My concern now is what should I do now to continue stomping the beast. TRT may be the answer. Do it now or wait till the beast comes back?

My last PSA was 0.1 and should go down some more . Treatment was July 7,2020.

PSA continues downward usually for about 6 months. I am searching for follow up treatment since German doctor says further treatments can be very hard on Kidneys etc. and to consult my American oncologists for further treatment. Therefor TRT is an option.

[Hidden]

I read with interest. Didn’t really apply to me, but.... I found the article woefully incomplete and will search for the complete trial data. I have used 4 mg of Androgel twice a week since 2011. PSA is still <0.1...... T ranges from 350 to 750 depending when I apply and when I have. Blood draw. T has a very short half time....

I say different because after Brachytherapy and IRMT I developed mets; underwent a six month chemotherapy trial with Lupron. Stayed on Lupron for six years. When I stopped, T did not come back; hence the addition of testosterone.

I don’t think that low dose TRT kills PCa cells, but BCR, if one is destined for, may or may not be delayed depending on the scope of disease remaining. T does make you feel better....... yet, ....... the main takeaway is that you, as well as I, are/were in a clinical trial, where your treating physician has a lot of leeway in treatment. It is very doubtful that one not in a trial would have TRT readily available. And, to get a script for testosterone, besides the very high cost, amounts to an act of Congress.

GD

[FinalBossMatt]

Wow, even though my body doesn't produce testosterone anymore other than my thyroid gland, if done safely, I would be down with this.

I am very fortunate for now that the only real effect on my body is I get more emotional than I normally do. Still though, to manage it, and have, at least something "Generic" for lack of a better term for testosterone, let's do this.

[MateoBeach]

Interesting to consider. This is not TRT in advanced disease like us guys. It is after initial primary treatment with RP or RT? In which case BCR is an indicator that there is remaining disease which will require further treatment such as SRT most commonly.

So delaying inevitable BCR is just hiding the indicator and therefore delaying SRT and thus making it less likely to be successful. Earlier is better IMO.

[George71]

I see it the complete opposite ... half as many had BCR (52% less) by having taken TRT -and even then -- the ones that had BCR on TRT were a year and a half longer before it happened.. And for some, It prevented BCR from happening entirely.

The other group were likely put on the ADT train (a year and a half sooner) which almost always leads to CRPC which is the last thing anyone wants.