Testosterone Treatment After Radical Prostate Removal

Nelson Vergel

Founder, ExcelMale.com
EAU 2019: Case Based Debate: Hypogonadal Prostate Cancer Patient Following Treatment with Curative Intent: Pro versus Con


Barcelona, Spain (UroToday.com) In this debate, Drs. Mulhall and Tombal debated the safety of testosterone replacement therapy in a prostate cancer patient. The index patient was a 58-year-old male with a pre-treatment PSA of 7.6 who, was 6 months status post radical prostatectomy for Gleason 4+3 prostate cancer with negative margins and an undetectable PSA, but symptomatic hypogonadism and erectile dysfunction despite tadalafil 5mg daily. It was noted that physicians concerns regarding testosterone replacement therapy are worldwide, stemming from the original Huggins and Hodges data that reduction of testosterone to castrate levels caused prostate cancer to regress whereas administration of exogenous testosterone caused prostate cancer to grow. However, more contemporary data shows no strong evidence on testosterone replacement therapy and prostate cancer and current EAU evidence-based guidelines is listed as “weak”.
Dr. Mulhall argued in favor of administering testosterone replacement therapy in the post-prostatectomy patient. Story continues here
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Normal range: 300-1000 ng/dL

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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