Question:I am on prostate cancer surveillance. Can I use testosterone?


a fool with a tool...is still a fool

I have a friend who is a doctor and has prostate cancer. We made the diagnosis about two years ago and he has elected to do surveillance. His level of sexual activity is improved with the addition of Androgel. He was at his internist’s office for a blood pressure check yesterday and the internist was surprised that he was on testosterone with his history of prostate cancer. He was advised to consider stopping it and then told to “Ask McHugh if he really wants you to be on testosterone.” My friend left me a message to call and he then asked me the question,” Should I be on testosterone if I have prostate cancer. I would like to stay on it if I could because I feel much better on it and it helps my sex life.”

Some opinions I have I have gravitated to over the years not because I read it, but that it just makes sense to me. On many occasions I would subsequently read in a journal that some study vindicated my thoughts. This is one of those situations. All men have circulating levels of testosterone normally. The range of the value is between 300-800. So…some men have a low normal testosterone and have no symptoms and some men have a high normal testosterone and feel they need more. What if a guy with a low normal testosterone had a value of say 300 and had prostate cancer with favorable parameters wanted to be on testosterone? What’s the harm? There are circulating hormones anyway. If it were an issue, why don’t we make men doing surveillance take something to lower or make the testosterone go down? We don’t do that do we?

So I look around on the archives of the Journal of Urology and find this article. Something I need to look up is a comment made in this article..that prostate cancer is more aggressive the lower the value of testosterone…interesting….verrry verrry interesting.

I sent the article to my friend and he said, ” I’m going back on it.” I think this is reasonable particularly if the PSA’s are monitored, which my friend is doing. There are more studies to come I am sure particularly since more and more men are choosing surveillance and more and more men are finding that they “just feel better” on testosterone. Here’s the article…what do you think?

Testosterone replacement in men with prostate cancer.

5 Replies to “Question:I am on prostate cancer surveillance. Can I use testosterone?”

  1. Dr. McHugh,
    This testosterone article was fascinating, but more than anything it made me wonder about the whole “active surveillance” scenario. Even when long term survival is the one and only goal, maybe active surveillance should still be the only way to go unless the initial biopsy is very bad? It seems to all boil down to what the statistics say about the long term survival of those doing active surveillance. What are those stats, and could you please comment about how your own long term active surveillance patients fare? Do very few or very many ultimately wish they had been treated earlier?

    Thanks,
    Jack

    PS Thanks for your timely follow-up over the weekend. I did have my catheter removed yesterday and am now happily incontinent, as I should be.

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  2. I am a prostate cancer survivor. My PSA was fixed at 8. I did radioactive seeds and radiation therapy ten years ago. I am doing fine except for my sex life. My libido is low and I suffer from erectile dysfunction. I am debating if I should go on testosterone therapy.

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