I'm stage 4 with oligo mets which I treat with Casodex and SBRT when they (usually one) occur.
My testosterone level is 120 which is low and I suffer all of the usual side effects of low testosterone. Since Casodex supposedly prevents prostate cancer from using testosterone, why wouldn't it be reasonable for me to use testosterone injections? Many doctors don't even want to consider that as an option. I would appreciate Tall Allen's take on this.
Casodex weakly blocks the androgen receptor on all cells, not just prostate cancer cells.
Does that mean testosterone would not be as effective as it would be without Casodex?
It means they do conflicting things.
Did you ever receive an answer to your question?
Sort of-- see the reply of Tall Allen and Grandpa4. Guess I won't pursue testo injectons.
Perhaps wait for a full set of answers.
if you gave enough testosterone to overcome side effects it would also overcome the block at the prostate cancer. In short the cancer woukd grow. I suggest exercise to deal with the side effects. Weighs and aerobic exercise.
I do weight training 4 days a week, and swimming or treadmill the other days -- and I have for years. Still, low T! My oncologist just dismisses it as 86 year old testicles. Ugh.
Thanks.
To shortPSADT
I'm older than you and my M.O. switched me over from Casodex to Nubeqa in April 2023 (and I'm still taking Lupron shots every 3 months). So far the Nubeqa has lowered my Psa. I'm being treated at MSKcc in NYC. I know it's late in the game for all of us, but would you please update your bio. Thank you!!!
P.S. keep working out....(caution if lifting weights).
Good Luck, Good Health and Good Humor.
j-o-h-n
Diagnosed 1999, Gleason 4+3, prostectomy 2000 and remained with PSA < 0.02 for 10 years, then suddenly PSA started to rise. Choline scans were new and experimental at that time, but it found a met on C-7 and lymph nodes. Radiation took care of that and ever since then I develop a met or two somewhere and have had success with SBRT over the years. Usually I get about 1.5-2 years before another met shows up. Casodex works very well for me and I've been on and off of it several times. Currently on Casodex and my only complaint is fatigue, etc. that I feel from low testosterone. That's why I'm hopeing to try testosterone injections but somewhat afraid of the consequences of doing so with stage 4 disease. Like some docs say, "you likely have many micromets and the testosterone will just encourage them to grow." But my thought is that even with normal levels of testosterone I only had mets growing every year or two, so why going back to normal T levels would be dangerous?
I have had undetectable PSA for > 2 years following triple therapy, T8 SBRT and whole pelvic radiation. My PSA didn't recover 18 months off Lupron so my JH MO put me on TRT under care of endocrinologist. Low T side effects gone. PSA still undetectable. Plan: If PSA rises get PSMA PET and SBRT to any visible met.
Thanks for the input.
If symptomatic relief is your primary goal, you might also consider low dose estradiol skin patches. They can be very helpful, including reducing hot flashes, restoring energy, and protecting your bone density.
Not all doctors are on board with this, fyi. Some work with old information, suggesting heart issues and so on. There is no such problem with bioidentical estradiol, taken other than orally.
I did try that a few years ago. It helped with fatigue but completely destroyed libido,
In my experience, it's the loss of testosterone that kills libido. Estradiol does not restore that, and it's one of the biggest shortcomings (along with a risk of some modest breast growth). But it takes care of just about everything else.
I agree,
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