Testosterone Therapy Does Not Increas... - Prostate Cancer N...

Prostate Cancer Network

4,933 members3,071 posts

Testosterone Therapy Does Not Increase the Risks of Prostate Cancer Recurrence or Death After Definitive Treatment for Localized Disease

Tall_Allen profile image
14 Replies

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:

prostatecancer.news/2020/06...

Written by
Tall_Allen profile image
Tall_Allen
To view profiles and participate in discussions please or .
Read more about...
14 Replies
rust profile image
rust

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?

Tall_Allen profile image
Tall_Allen in reply to rust

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.

rust profile image
rust in reply to Tall_Allen

2.5 month PSADT after T replacement therapy and now PSAHT (halving time) of 2.5 months under treatment. Go figure.

Tall_Allen profile image
Tall_Allen in reply to rust

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.

rust profile image
rust in reply to Tall_Allen

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.

Haniff profile image
Haniff

Thanks Allen

Good to know and to have in the literature bag 😉

Appreciate your sharing

❤️

Haniff

bhayes84 profile image
bhayes84 in reply to 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?

Haniff profile image
Haniff in reply to bhayes84

🤔

addicted2cycling profile image
addicted2cycling in reply to bhayes84

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.

Tall_Allen profile image
Tall_Allen in reply to addicted2cycling

You had cryoablation of your prostate, right?

addicted2cycling profile image
addicted2cycling in reply to Tall_Allen

YES cryoablation plus the 3 drug immunotherapy injection. Managed to complete a 101 mile bicycle ride today just before the rains came. ;0)

Tall_Allen profile image
Tall_Allen in reply to bhayes84

You can dry out a sponge, but a dripping wet sponge can't get any wetter.

Adf2529 profile image
Adf2529

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.

Jp2sea profile image
Jp2sea

I saw this study but am not ready to pursue. I like to think of me as single case.

You may also like...

Timing of Androgen Deprivation Treatment for Men with Biochemical Recurrent Prostate Cancer in the Context of Novel Therapies

Conclusions Men with biochemically recurrent prostate cancer, who defer hormone therapy until...

Should SBRT be THE preferred treatment for intermediate risk prostate cancer?

Unfortunately, not enough patients meet with a radiation oncologist who specializes in SBRT. While...

Survival after Radical Prostatectomy versus Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer

for very high-risk men. https://pubmed.ncbi.nlm.nih.gov/34555930/ Not a randomized study, but will...

Brief, intense radiation and hormone therapy for very high risk prostate cancer

that SBRT may be as good as brachy boost therapy for very high risk patients. They added a short...

FDA rejects TOOKAD focal treatment for low-risk prostate cancer

this article to reflect the rejection this week of a kind of photodynamic therapy for low-risk...