Re: Testosterone therapy

[Guest guest]

Chuck:

Thanks for your comments and your paper (received off line). For those forum

readers who have not read the paper, let me summarize and ask Chuck (its author)

a few questions:

1. Chuck (I assume that was you talking) does not advocate testosterone

replacement therapy (TRT) unless administered by one of the recognized PCa

oncologists.

2. Chuck's paper referenced several other papers authored by oncologists and

other MDs. The picture is confusing, but my impression is that these authors

recognize that naturally ocurring low levels of testosterone (presumably what I

have due to aging) are enough to feed the beast (provide it water to slake its

thirst to use Chuck's analogy) and that any more testosterone (bringing it back

to youthful levels) does no harm, ie the beast's thirst was already slaked.

3. The various referenced authors (and Chuck) do not recommend any consideration

of TRT unless PSA levels have been consistently very low (<0.05) which is not my

case.

So all of this is rather contradictory and confusing. But in my case I neither

have consistenly very low PSA readings nor easy access (I live in eastern NC) to

recognized PCa oncologists. So I probably should forget about TRT.

[Guest guest]

> I am 65 years of age an almost 6

> years post RRP and except for this most recent PSA test-

> 0.13 with a new lab, all previous tests have been reported

> as <0.1.

>

> Erectile function is tolerable, sufficient for penetration,

> but vaginal orgasms just don't happen anymore. I can have

> one manually, but the real thing is better, right!!

>

> So prodded by all of the TV ads, I am wondering if my

> testosterone level is really low and is there anything that

> can be done about it. My internist who I saw today (he

> reported the 0.13 PSA reading) was not too thrilled about

> doing anything to boost my testosterone level. And I don't

> really know if it is low.

>

> So is testosterone replacement therapy even in the cards

> for a PCa survivor? It would seem that as long as the PSA

> level (before any testosterone therapy) stays very low, then

> the risk of additional testosterone " feeding the demon " is

> less than the average man on the street who may or may not

> have the " demon " . I don't think I have any " demon " anymore.

>

> What are your thoughts?

>

>

,

I know that you have been agonizing over this for many months and

have posted the same question in this and other groups multiple

times over that period. It is clearly an important issue for

you and one which you cannot resolve.

As I recall, you wanted to try TRT in order to treat tiredness

and perhaps depression and other symptoms which you think may be

associated with low T.

Here are my thoughts on your questions:

First of all, the PSA of 0.13 is new and important. If it

indicates a recurrence, which it probably would if the the result

is accurate, then you may have a problem that might merit a lot

of attention. I'm no expert but, as Chuck pointed out in his

responses and in his paper, I would think it should certainly

affect any plans regarding TRT. I would think you would want to

find out as much as you can about any possible recurrence before

making any decision in favor of TRT. Even if you have firmly

decided against TRT, you ought to check out the PSA rise.

I suggest getting a PSA retest. If the number is still above

0.1, then I would also suggest that you try to consult the very

best radiation oncologist that you can find. You might try one

of the research hospitals nearest you. There is one in Durham

and one in Chapel Hill. See:

http://cancercenters.cancer.gov/cancer_centers/cancer-centers-list2.html#NC

If you do have a recurrence, prompt action might (or might not,

there are no guarantees) make the difference between being cancer

free and battling it for the rest of your life.

I also think that you should do your best to find out what is

causing the symptoms that you hope TRT will treat. Some men who

have tried TRT for tiredness or lack of energy have found zero

improvement. Presumably, T level was not their problem. It

might not be yours either.

These things are very hard to track down. Most doctors don't

want to help you with a problem like this. It's too non-specific

for them and some are inclined to write off the problem as

psychological - which of course it can be in some cases. They

want to give you an anti-depressant - which might help if

depression is the real problem, but probably shouldn't be taken

if there is no clinical evidence of depression. The doctor

should be able to say what the evidence is before he prescribes

such a drug.

It is conceivable that an endocrinologist could help. It's also

conceivable to me that a phyical trainer or dietician could help.

Maybe the right physical training and diet can build up your

energy and stamina. Or maybe not. I'm no expert and even if I

were I wouldn't be able to provide advice without talking to you

at length.

And of course, as Chuck recommended, you must get a testosterone

level test before even thinking about TRT. I seem to recall that

you've had them in the past and that your T level was low, but I

don't remember what it was, and it may be different now.

Best of luck.

Alan

[Guest guest]

> I am 65 years of age an almost 6

> years post RRP and except for this most recent PSA test-

> 0.13 with a new lab, all previous tests have been reported

> as <0.1.

One more thing about that.

In one of Dr. " Snuffy " Myers videos I recall him saying

that if a man has a recurrence 6 years after primary treatment,

his cancer is slow growing and treatable with medical means.

Such men are very unlikely to die of prostate cancer - assuming

that they can get good treatment.

So although I recommend checking out salvage radiation, I don't

think at all that you are condemned to death by PCa if you don't

get it or if you get it and it doesn't work.

> Erectile function is tolerable, sufficient for penetration,

> but vaginal orgasms just don't happen anymore. I can have

> one manually, but the real thing is better, right!!

Now here's a truly interesting subject that I passed right over

in my concern about your cancer.

In my personal opinion, having experienced decreasing potency for

some years now since my radiation, I'm inclined to say No, it's

not better. If you've got a willing and teachable partner, and

if you use some imagination and engage in experimentation, you

can find routes to orgasm that are absolutely as good as the old

standard, and sometimes better.

Be creative. There might be a world of new and interesting

experience out there for you.

Alan

[Guest guest]

Alan:

Thanks for your comments, but you have me confused with someone else. This is

the first time I have posted on this topic. I am not depressed and my energy

levels are fine. The only traditional symptom I have of low T is decreased

sexual function.

[Guest guest]

> Thanks for your comments, but you have me confused with

> someone else. This is the first time I have posted on this

> topic. I am not depressed and my energy levels are fine. The

> only traditional symptom I have of low T is decreased sexual

> function.

Sorry for the confusion. There was another guy who I seem to

recall was named Dave also, with a similar concern. He was tired

all the time and thought that more testosterone might help.

As I've gotten older, I'm now 65 also, my libido has declined and

my sexual capacity too. As far as I know, it's a very natural

part of aging and it's not entirely due to declining

testosterone. I'm not an expert and may be wrong, but I suspect

that if adding more testosterone helps, it might not help much.

Unfortunately, there's nothing that can turn us into teenagers or

young men again.

But hey, I can still enjoy looking at a woman as much as I ever

did :^)

Alan

[Guest guest]

> But hey, I can still enjoy looking at a woman as much as I ever

> did

Right on, bro!!!