In the largest observational study so far, Sarkar et al. reported that men in the US Veterans Administration (VA) database who received surgery or radiation for localized prostate cancer and then received testosterone replacement therapy (TRT) for low testosterone were at no greater risk for recurrence than a matched sample of such men who received no TRT.
Here's an article about it:
Looking forward to this thread! I asked for TRT 3 years after treatment and it awoke highly aggressive recurrence which oddly enough also is highly hormone responsive. And hormone responsive cancer cells are what we prefer to have more of. Wondering what will happen next after having completed Taxotere, 9 mos. ADT and pelvic node radiation. PSA wound down same rate as PSADT prior and is at 0.14. Will remission be stable or fade after ADT loses it's charm?
You have no idea what would have happened if you hadn't taken TRT -possibly the same outcome. Who knows? But your experience reminds us that close monitoring is important.
2.5 month PSADT after T replacement therapy and now PSAHT (halving time) of 2.5 months under treatment. Go figure.
What do you think that tells you? Did it change the pattern from slow progression followed by fast (which is typical) to fast progression followed by slow with no net difference? No way to know.
The PSA doubling time for me after biochemical recurrence was always constant at about 2.6 months under no therapies - - exponential growth indicative of a tumor. My recent triple therapies (chemo, ADT and node radiation therapy) appear to have knocked back the disease but a radiation oncologist commented that success of nodal radiation therapy may hinge on whether the primary tumor site lay within the treatment field. My urosurgeon at Urology Centers of Alabama was puzzled as to why I had recurrence as my prostatectomy was mostly clean at T2C, G3+4 even with a 4 mm positive margin followed by 65 Gy to the prostate bed 12 months later. So if the primary tumor site was within the first radiation treatment field, perhaps some cancer cells had escaped into the lymph node ducts that drain the prostate bed and lay there dormant until testosterone replacement therapy after which they multiplied into the string of adjoining lymph nodes to the peritoneal area.
In our previous discussions you have certainly countered with the strong possibility that disease may be microscopic, systemic and likely incurable. Emory University was in agreement for lack of evidence of disease location with Axumin imaging. However scans at Mayo Clinic (later when PSA was higher) confirmed disease in peritoneal lymph nodes and prescribed an aggressive treatment plan. While I am cautiously optimistic about a durable and long-lasting remission with a PSA of 0.14 four months after radiation I am still also only 9 months into initial ADT mono-therapy. If my PSA decrease trend continues the PSA should be 0.07 or lower in July. Then what, ADT for 12-24 months more or orchiectomy and Cypionate injections like addicted2cycling opted for below. Mayo Clinic seems to think I have a reasonable chance at remission and may be able to discontinue ADT at 24 months.
Thanks Allen
Good to know and to have in the literature bag 😉
Appreciate your sharing
❤️
Haniff
I've always found this a bit confusing. Given this definition:
"Hormone therapy for prostate cancer is also known as androgen deprivation therapy (ADT). Prostate cancer cannot grow or survive without androgens, which include testosterone and other male hormones. Hormone therapy decreases the amount of androgens in a man's body."
The only explanation I can think of is that if you don't have any cancer cells then of course TRT can't cause it. However it seems to me that if you have any cancer cells then having TRT is feeding the beast.
Although I see this line in the article:
" Morgentaler's testosterone saturation theory says that above some minimal testosterone level (around 120 ng/dl), adding more testosterone does not further encourage prostate cancer"
So I guess that means once you're off ADT your T levels rise back up and cancer doesn't get any worse if you go above those normal levels.
Comments?
GL10 in 2015 approaching age 65 in EXCELLENT FITNESS HEALTH with my naive research indicating ADT or Orchiectomy was required IMMEDIATELY. My urologist advised ADT and I told him Orchiectomy. MINOR side effects resulted compared to those being mentioned by ADT users as my endurance exercise continued but with anticipated decline. Treating physician CONTRARY TO ACCEPTED MEDICAL PROTOCOL prescribed TRT (Cypionate injections biweekly) 1 month following treatment and no turning back. My T shoots to 1600+ following injection (just had injection YESTERDAY) and if I vacation for 2 extra weeks I can lower it to 20+/-.
I am my own study and NOT some obscure trial that is being written about within the medical profession while many suffer and wonder. Will it kill me or allow me to continue as if ALMOST NO CHANGE IN MY LIFE HAS OCCURRED ??? ONLY TIME WILL TELL.
It is now 5:00AM as I write this and I am preparing to begin a bicycle ride of 70 miles as that will be my age next month. Don't know where I would be if I had done ADT.
You had cryoablation of your prostate, right?
YES cryoablation plus the 3 drug immunotherapy injection. Managed to complete a 101 mile bicycle ride today just before the rains came. ;0)
You can dry out a sponge, but a dripping wet sponge can't get any wetter.
I had SBRT last November. I decided on TRT after consulting with docs. My T levels are normal. Feeling much better overall. Will have to keep watching PSA over time but isn't that the case for us all.
I saw this study but am not ready to pursue. I like to think of me as single case.
Low testosterone is associated with extremely poor survival metrics, post-ADT.
Hemorrhoid treatment after Brachytherapy for Prostate Cancer
Post radiation and low(er) testosterone
