TRT & prostate cancer: Why can't you do... - Prostate Cancer N...

Prostate Cancer Network

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TRT & prostate cancer

ocman
ocman

Why can't you do TRT if you control DHT & Estrogen?

27 Replies
Hidden
Hidden

Because you probably won't find a doctor to participate in such treatments. Unless in a clinical trial.

ocman
ocman in reply to Hidden

If you could, would it work and would it be safe...

Hidden
Hidden in reply to ocman

I think not and that is why probably most doctor's wouldn't even consider it outside of a clinical trial...you are putting gas on a fire, with the hope by adding fire retardants you will will prevent a conflagration. Unwise in my non-medical opinion.

Have you asked your Urologist and/or Medical Oncologist about this? If so, what did they respond with?

ocman
ocman in reply to Hidden

Yes, the MO said should wait 1 year after HDR Brachytherapy (monotherapy) and the RO said wait 2 years, and the Urologist was willing to do it now...

Hidden
Hidden in reply to ocman

I don't think my MO or Urologist would sign off on TRT given my pathology...you must be in a low risk group...I am not.

ocman
ocman in reply to Hidden

My info is in my profile...4+3...

Hidden
Hidden in reply to ocman

You might be able to pull it off....you are not stage 4 like I am.

Good luck...would like to know your results.

ocman
ocman in reply to Hidden

My RO really wants me to wait 2 years past treatment, I just passed 1 year this month...I will certainly post info if I proceed. Looking for more opinions as well...

RSH1
RSH1 in reply to ocman

I'm high risk. In 2019 I had RP and the doctors at Mayo gave me two months before the aggressive return of cancer. I did 6 months of estrogen patches (a form of ADT). After that, I started high testosterone (400 mg weekly of cypionate). My testosterone measures 2100 - >3000 (lab cutoff).

My free test is almost 100. Bio-available runs 500-600.

So far I have no evidence of cancer. I'm sure it's still there though.

At first, my MO was very against the use of testosterone. I did it anyway. As of 6 months ago, she told me to "keep doing what you're doing because it's working".

So, obviously works for some of us. I control estrogen (keep estradiol or E2 around 20). I used to use DHT blockers but for the last few months, I've been letting DHT float up. An experiment of sorts. NIH research shows that DHT is even more powerful than testosterone to kill the cancer. A possible mechanism is calcium ion influx through voltage-gated calcium channels (VGCC). Another is double-strand DNA breaks.

A nice side effect is that I've gained 30 lbs of muscle and 0 lbs of fat (so fat percentage decreased and now it is single digits). I eat like a horse and can chow down like I did in my 20's.

Lot's of studies too. NIH, Johns Hopkins, etc.

Because it would mask a recurrence.

How would you control estrogen and DHT when using TRT? I would like to boost T but other factors are already too high.

Arimidex for Estrogen and Finasteride for DHT

RSH1
RSH1 in reply to ocman

I started with Arimidex. I bloated up. I switched to Anastrazole. Same thing. Letrozole works like a charm, fortunately.I used Finasteride and also Dutasteride.

If it masks it, that doesn't completely explain why my last scans were perfectly clean. Before I had them my MO was 100% positive that they would be negative.

PSA fluctuates between <.01 and 0.06. No cancer signs. Nada. I have two doctors today and they both think my prognosis is great based on my metrics and lack of signs or progression.

ocman
ocman in reply to RSH1

Who's your MO?

RSH1
RSH1 in reply to ocman

Dr. Amber Flaherty.

RSH1
RSH1 in reply to ocman

I don't get the testosterone from her. I get it legally from another doctor. I hesitate to give his name out on this site because of some very biased people who might think it is their moral "duty" to report him (or her or it).

Check out Dr Denmeade and his work on Bipolar Androgen Therapy (BAT) I have a PDF of his work if you cannot find him on the net

lancer

RSH1
RSH1 in reply to lancer82801

Dr. Denmeade is doing some much-needed work in this area. It looks like I am a hyper responder but it would be great for others if there was a way we could determine who might respond and who probably won't.

lancer82801
lancer82801 in reply to RSH1

Yes that would be nice. I had 400mg Testosterone Jan 04,21 with a PSA of 0.04 and Testosterone of 8. On 02-03-21 my PSA was 0.12 and Testosterone was 329 This all in the face of Estradiol patches maintaining my estrogen level at around 150Will test again this week to see

RSH1
RSH1 in reply to lancer82801

It took approximately 5 weeks for the estrogen patches to kick in.

How many patches and what dose/freq are you using?

lancer82801
lancer82801 in reply to RSH1

I started with 4 0.1mg Dottie Estradiol patches twice weekly. 6 weeks later i went to 2 of same patches twice weekly PSA has maintained at 0.04 for last 5 months

RSH1
RSH1 in reply to lancer82801

And then it just bumped up to 0.12?

And you've been on the estrogen for how long?

The patches are biweekly?

I used weekly patches. I targeted my T to be 0. Took between 0.2 and 0.4 mg a day. I used weekly patches (each one providing 0.1 mg a day).

I don't think this played a part but is important to mention,: my doc put me on zytiga. The reason I don't think that the zytiga was responsible was that I started one day before my blood test that showed T was 0. I think zytiga takes a week or so to take effect. But I can't prove that the zytiga didn't help. I wish I would have waited a day before starting it...

lancer82801
lancer82801 in reply to RSH1

Estradiol since Sept 2020 again biweekly 0.1mg 2 patches changed on Tues and Friday The PSA popped up after the 400mg Testosterone cypionate IM No other treatment

RSH1
RSH1 in reply to lancer82801

Were you doing cyp with the estrogen?

I try to hold my estradiol (E2) down to 20-25 pg/ml when I do cyp (last 17 months).

Some guys use DHT blockers when they do high T. I did for a while but now I'm letting the DHT go high (going very high since 5-10% of T is converted to DHT).

What is cyp?

GabF
GabF in reply to lancer82801

= Testosterone Cyprionate, one of the two usual forms of TRT. The other is enanthate.

lancer82801
lancer82801 in reply to GabF

Thanks got it. I just had one injection of 400mg Testosterone cypionate. and am maintaining estradiol patches (2) 0.1mg patches changed twice weekly

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