testosterone a feeder of prostrate cancer

[Byron sparkman]

thanks everyone for all the T questions . However im not seeing questions on keeping T low because it feeds prostrate cancer. i had my prostrate removed on may 12 2021 and stay in contact for 6mo checks of PSA levels. thankfully it has been 0.0 all this time. and the question has been asked several times about taking T , since it is low , and i feel the lack of stamina , etc... if anyone is in this same situation please advise your experences. please. thanks bighorn

 

[RickB]

Prostate dude. Just one "r".

The more knowledgeable members will explain it better, but the studies used to link the two were either flawed studies or used flawed logic.

 

[MDavidW76]

Androgen hypothesis from the early 1940’s by chance?

 

[Systemlord]

However im not seeing questions on keeping T low because it feeds prostrate cancer.

https://www.urology.uci.edu/pdf/The_Impact_of_Low_Free_Testosterone_on_Prostate_Cancer_High_Risk_Disease_Recurrence_and_Testosterone_Replacement_after_Radical_Prostatectomy.pdf

 

[Mountain Man]

If you can find the videos from Dr Abraham Morganthaler he can explain the flawed studies and how testosterone is actually protective.

 

[Systemlord]

 

[madman]

thanks everyone for all the T questions . However im not seeing questions on keeping T low because it feeds prostrate cancer. i had my prostrate removed on may 12 2021 and stay in contact for 6mo checks of PSA levels. thankfully it has been 0.0 all this time. and the question has been asked several times about taking T , since it is low , and i feel the lack of stamina , etc... if anyone is in this same situation please advise your experences. please. thanks bighorn

Most up-to-date info you will find on the subject!

You would need to find/work with a doctor who specializes in this area!

Look over the thread in post# 6.

Testosterone Replacement Therapy and Prostate Cancer

Testosterone Therapy and Prostate Cancer Incorporating Low-Level Evidence into Practical Recommendations (2023) Alvaro Morales, MD, CM, FRCSC*, D. Robert Siemens, MD, FRCSC1 INTRODUCTION In men’s health, 2 fields share the characteristics of being both controversial and involving several...

www.excelmale.com

RELEVANT CLINICAL SITUATIONS

A contributing factor to some of the controversial issues involving the interactions between androgens and PCa stems from the ambiguity of the clinical situations under discussion. There are 3 pertinent clinical situations:


Hypogonadal Men Without the Evidence of Prostate Cancer

It has been determined and broadly accepted that men with a clinical picture of hypogonadism and biochemical confirmation of abnormally low T are candidates for TTh.36 Unfortunately, a significant number of men are reportedly prescribed T without having basic laboratory evaluations37 and sometimes for flimsy clinical evidence as a cure-all for the infirmities of aging. Guidelines by recognized specialty societies, universally concur36–38 with the need for baseline investigations. There is no justification for giving T without ruling out potentially serious health issues that may further deteriorate as a consequence of T treatment.39

Contemporary recommendations, regarding prostate health, are that symptomatic hypogonadal man can safely receive TTh.36–38,40 Monitoring during treatment includes the requirement of baseline documentation by a digital rectal examination (DRE) as well as a measurement of prostatic specific antigen (PSA). It is also recommended that these should be repeated every 3 months during the first year of TTh and yearly thereafter.




Hypogonadal Men Successfully Treated for Cancer of the Prostate (CaP)

Technically these men would be classified in the previous category, the reality is different and still evolving. There is a significant body of evidence indicating that they are candidates for TTh:


*Still inconclusive but compelling evidence shows that following radical prostatectomy, men with symptomatic hypogonadism can safely receive supplemental T.41,42

*Smaller but equally encouraging evidence has been presented for similar patients treated with either brachytherapy43 or external beam radiotherapy.44,45

*Studies supporting these views warn that the findings are hypothesis-generating and require confirmation with multicenter controlled trials.46




A paramount concern in this scenario focuses on the timing TTh; it has not been established but has been vaguely described as “after a prudent interval”.47 This, of course, is of limited help to the clinician. It is our belief (without much evidence to support it) that for those who underwent radical prostatectomy the “prudent interval” is achieved once the PSA is no longer detectable. Consideration must be given to the histopathological information of the surgical specimen (grade group, margins, stage). We advocated for a potential advantage of the early initiation of T supplementation in that an elevation of the PSA may indicate incomplete ablation of cancer, in which case additional curative measures may be considered; something akin to a challenge test48. This concept received support at the 2021 AUA meeting whereby Mulhall and colleagues49 reported on a prospective study of hypogonadal men who had undetectable PSA after radical prostatectomy and were challenged with T administration. Persuasively, those who had an elevation of the PSA following TTh (10%), had detectable disease on imaging.

The situation is more complex for those with low or intermediate PCa who underwent radiotherapy without ADT as undetectable PSA levels might not be attainable. For these men, we would consider the initiation of T treatment after a persistent PSA nadir (>6 months) has been reached.

This cohort demands a close and competent follow-up, particularly in the initial months of TTh. There is no justification to initiate TTh without baseline determinations including T and PSA which are reported not being measured in about 30% of patients in this category in the United States.50 Monitoring is equally important and frequently ignored.51




SUMMARY

Current evidence strongly supports that hypogonadal men successfully treated for PCa can safely receive TTh. For those harboring untreated PCa the picture is less clear as this group of men undoubtedly expands due to acceptance of AS as the preferred initial treatment strategy91 and experience increases with emerging technologies such as MRI and genomic testing,92–94 prostate-specific membrane antigen PSMA theranostics,95 and fear of complications or regret of treatment choices.96

There is a lack of guiding criteria for the general urologist who should be cautious and embark on it with a great deal of thoughtfulness. For untreated PCa there must be strong valid reasons for not moving forward to curative treatment and an equally strong one for TTh. For the unsuccessfully treated, BAT is a promising oncological option although requires much more prospective study given the ever-changing landscape of CRPC.

Urology should strive for higher levels of evidence, such as clinical registries or other correlative observations from prospective trials, to characterize those clinical scenarios whereby men with TDS and PCa would benefit most from TTh in terms of quality of life. The considerations that we must take into account include the specific baseline patient and cancer characteristics as well as the particular stage in their cancer journey. In addition, we should endeavor to establish the criteria to initiate/discontinue TTh, requirements for follow-up, and T formulations to use. These are essential needs for wide acceptance of the evolving paradigm.

 

[madman]

https://www.urology.uci.edu/pdf/The_Impact_of_Low_Free_Testosterone_on_Prostate_Cancer_High_Risk_Disease_Recurrence_and_Testosterone_Replacement_after_Radical_Prostatectomy.pdf

Search function, anyone?

 

[Systemlord]

Search function, anyone?

View attachment 29041

It's not working for me. I have the exact name of previous thread recorded in a personal log, type it in and strike out.

I have the link saved on my iPad and was able to click on the link and go right to it, type it in the search function and no go.

 

[madman]

It's not working for me. I have the exact name of previous thread recorded in a personal log, type it in and strike.

All you had to do was mention it to OP!

Invaluable tool on here!