I went to my doctor and she said that a PSA is needed for screening purposes. I asked why and she said that TRT can cause cancer. I told her I have heard nothing of this and if it does I would have never started it. I have read that being on TRT can fuel cancer that is already there making it grow faster and more likely to be agressive in nature. She looked at me with a puzzled look and said really well maybe you are right I will check into it. OMG! this is my doctor. Now what the heck am I supposed to think. I have never read anything that links TRT to causing cancer, fueling it yes, but causing it no. I have also read that men with low T are at a higher risk of developing cancer so it would be safe to say I am better off on TRT than not. I wouldn't be on it, but my body no longer makes it so it was 0. My side effects from this were really bad. It is like having chronic fatigue syndrome and sexual difunction. With a side of extreme depression. It was terrible and I don't want to go back to feeling that way, but the doctor would like me to stop due to cancer risk and blood clotting. I am getting checked regularly for blood issues and have no desire to take a PSA test. I believe it will open Pandoras box. I wish to leave it alone. What is a guy supposed to do? It is a catch 22 no good answer.
Your situation is one of those instances in which the medical community have been misled by faulty research published a century ago. That study was poorly performed, had no controls, yet has influenced modern medicine up to the present. On the other side of the coin there are literally hundreds of peer reviewed publications showing a strong link between low T and prostate cancer risk. Even worse, studies have shown that T depletion as a treatment is highly likely to make prostate cancer more likely and perhaps also more aggressive. Surprisingly, many if not the majority of physicians still have not gotten the message that TRT is the way to go when the patient has low T. As for PSA, that test is highly controversial as it is notorious for false positives alarming patients and leading them unnecessarily into getting prostate biopsies that are notorious for false negatives, yet are the most used diagnostic tool for prostate cancer. Far better for diagnosis of suspect prostate cancer is MRI of the prostate with visual guidance of the biopsy needle to the suspect tumor. That said the PSA remains the best early detection of prostate cancer. PSA testing has a high false positive rate but a low false negative rate. Therefore a normal PSA is, although not infallible, reassuring. A positive PSA is scary but probably the vast majority of positive PSA tests turn out to be false alarms usually associated with bph which is highly coo on in males over age 50. So yes you are correct in your assessment. This area of medicine is a mess. But it's the best we have so you have no choice but educate yourself and if necessary your physician as to how you intend to negotiate this maze of options to make sure you get the correct diagnosis and treatment. Sadly you will have to be proactive and work closely with your physician, and yes, don't be shocked if you come to realize your information is better than your physician. As patients we really have no choice and rolling the dice and hoping for the best is not necessarily your best option.
True, I have heard that starving the cancer by denying testosterone does seem to keep it from growing, but I have also heard that it is a good idea to enact TRT in order to prevent it from coming back. In my case I hope I started TRT soon enough to get the benafits of it. I started it at age 38. I am now 47 and having symptoms of BPH, so needless to say am really scared to have a PSA test done as I am sure it will be high. I don't want to end up being biopsied for no good reason. The mental stress this can cause someone is pretty high. I don't wish to have my PSA taken for that reason, it would be detrimental to my mental stability. I have explained that to my doctor and she didn't understand why I felt this way. I understand why she doesn't agree with me, but she doesn't really want to respect my wishes. I don't think a doctor should give a man a PSA test without first explaining to him what to expect.
Craig, I go to a Holistic Doctor occasionaly and she recommended I take the hormone DHEA (Dehydroepiandrosterone) to boost my testosterone levels. DHEA is normally produced by our adrenal gland but after our 40's production can be cut in half. DHEA is the building block for our bodies to make testosterone. I'm 65 and my testosterone levels range from 340 to 600 ng/dL. I take 10mg of DHEA daily. Might be a consideration for you to look into.
Let me ask you does DHEA cause your prostate to enlarge? I have been thinking about taking DHEA, but didn't get any yet as I have a prostate that is enlarged making it difficult to urinate. My testosterone is only at 400 last time it was checked. It was as high as 1600 but the doctor made me reduce my level. I would prefer it to be 600 to 800. This is when I felt the best. Without TRT I was at 0 to 30. Pretty much non existant. This I found out can increase the risk of prostate cancer. So I need to maintain my level. If the doctor takes me off of it my risk will go up again. I feel like they are trying to kill me.
Hello I have read that TRT does not cause cancer but If you have prostate cancer it will make it worse. Mine is low I am on a testosterone gel for almost a year and have no problem Take care Ken
Craig,, I do understand your concern and anxiety over taking the PSA. I admit freely I too am anxious every time I take the PSA and at my age, 73 years, I take the PSA annually. And to to your point I have e peri ended on several occasions elevated PSA levels, that if taken at face value would have bought me a ticket for biopsy. In every instance of my elevatedSA reading, I had a spurious result and each instance was caused by a different reason. My most recent PSA at age 73 was 1.1. Here is my take home point to you: false positives for cancer are to be expected on the PSA. False negatives, are rare. So a good result on your PSA is and should be to you highly reassuring. And if one PSA comes back positive, just wait a week and take the PSA again. Keep in mind if you take a dozen repeat pSA exams and they are all elevated then you may indeed have prostate cancer and then the next step would be a biopsy. As for my false positive PSA readings, the first time it happened it was a lab error. The next time, I had had sex the day before and sex causes a rise in PSA. Another instance, it was caused by running the day before the test and yet another was caused by riding my Mt. Bike. So now when faced with an impending PSA and abstain from all those fun activities a full week before the blood withdrawal. So you see, you do have a lot of control over what happens on your PSA exam. Whatever you decide to do, do not allow a Urologist to persuade you to take a transrectal prostate biopsy usually conducted in their office. If you are convinced you need a biopsy have it performed via MRI imaging. You may have to travel to find an MRI guided biopsy of the prostate. Think OS the MRI guided prostate as using a guided missed to find a specific tumor. By contrast the transrectal approach uses a shotgun approach which is painful, has a high infection rate, and may even cause your prostate cancer to spread outside of your prostate, assuming one did actually have a prostate cancer. Bottom line, prostate cancer if you catch it early, is a fixable disease and you may even be able to eradicate your cancer without sacrificing your prostate, sex life, and quality of life. So man up and go get that PSA done.
Wow, nice low PSA score. At your age that is golden. I thank you for the response. I am worried because my prostate is enlarged and causing issues with urination. I believe it is due to prostititus. I have had this happen to me when I was younger and it always went away on it's own. As far as biopsy, I would never let them do the transrectal method on me. I have done a lot of research on it and I would do what you said. The only problem is cost. If insurance doesn't cover it I would be unable to have the MRI type. Not sure what I would do then. I am low risk as far as no one in my family has ever had prostate cancer. I am low in testosterone and vitamin D so I have read that I am at increased risk because of this. So naturally scared. Every time I go to the doctor they seem to find something else wrong with me. I have Crohn's disease, Osteoperosis, IBS, Severe Spinal Stenosis and sleep Apnea so far. I really don't want to find out I have cancer. It would crush me mentally. I hear what you are saying though could be good if I test under 2.5. But how. Maybe take extra prednisone.
I think it is good to have a PSA. It gives you something to go by but you have the final said. There are likey you say false positive and false negatives. I had one when I was 47 took 10 needles turned out to be a prostate infection. Men what ever you do told don't let a doctor talk to into having the prostate remove find out were the cancer is and what kind you have . If it is in the back of the prostate or on the bottom. That is a slow growing cancer. Most of the time you have 10 to 15 years before it become a concern.. There is a artical that all men should read. " I want my Prostate Back. " Remember guy he will only give you some of the information you have to research it yourself. Most doctors tell you that your sex life will be the same only you will have retro but want they don't say is that if they remove the prostate your sex will not be the same . It takes up to 2 years to get it back and that is only if you can and your erection will be less. So please think before you do anything. Take care my friends Ken
Most of the casual information on PSA and prostate cancer seems to be just so much hype. It's your body and you decide what is acceptable. I.m almost 71 and I have been on TRT since 1996 and have a s PSA blood-test as part of my well-man annual examination. I have never thought of this as any big deal and it actually puts my mind at ease knowing that the level is not rising.. My advice would be to not make a firm decision until you have had the test at which point you would know what the probability of prostate problems really is. You can always say NO at any point. Best of luck with your decision whatever it is.
That is my point, I don't want to go in for a biopsy unless they are absolutely positive that I have prostate cancer. If my PSA is high I tend to worry and that alone can have big consequences for me not to mention I would want to make sure it isn't so I would have to have a biopsy done. I want to avoid biopsy at all costs. I am sure that I have prostititus but I think it is caused by fungus not bacteria. It is a bad thing to biopsy an infected prostate because you risk sepsis,
It is hard to say no if your PSA is high because you will be thinking that you might have cancer. So at that point it is hard to say no to a biopsy. If I ever have to have one it will be a MRI guided biopsy done through the are between the scrotum and the anus. I would never let them do the Transrectal type on me. the guided type cuts down on damage by using fewer needles and very low chance of infection because they don't go through the wall of the rectum. I can't believe they still take biopsies transrectally. This is brutal and inhumane.
Unless you already know that your PSA is high, I would wait and get some facts under my belt before agreeing to anything. It's your body and if you need time to find out about any suggested procedure then you should take as long as you want and get indepndent confirmation of what you are told. It may take a little longer but the wait should be worth it. Medical staff often believe that they have power over you because of their knowledge but the power is yours!
I know of several friends with suspected cancer and they have lived with it for years without invasive surgery.
That is true. Get more information before you agree to anything. Prostate cancer most of the time is slow growing. It takes 10 to 15 years for any problem and in that time you can enjoy life before you have it taking away if you know what I mean..Take care Ken
Yea the dendency is to rush you in for a biopsy, then if positive they want you to start treatment right away. Heck the biopsy itself can cause permanent damage. The doctors act like it is no big deal, but it isn't them getting needles shot through their prostate.
Craig,
I believe your doctor is so wrong. The book " Testosterone for Life"by Doc.Abraham Morgentaler will answer your questions about TRT & cancer.The information from this book & other sources have helped me overcome the problems you describe. For what it's worth at age 70 my 5k racing time had dropped to 22:31 & I enjoy chasing my wife aroung the house. I don't recommend easily but I do this book. Ronnie
Hi craig84609! Go to Amazon, and read as much of the below-mentioned book as you can in Amazon's "preview" section, called "Look Inside." I bought this book in 2010, and have been using testosterone injections ever since (one ml per month) and, if anything, they've helped me. The book was written by Harvard's Chief of Urology.
Hope this helps: "Testosterone for Life: Recharge Your Vitality, Sex Drive, Muscle Mass, and Overall Health"
Hi alan, I started my testosterone top-up using the stick-on patches but found that my skin reacted really badly to the stuff that carried the testosterone so I used to have the injections in my rump but over a number of years the muscle hardened and the injections became less effective and had to be more often so i switched to the gel sachets. The gel is applied to the shoulders or belly once daily and they seem to be just as effective as the injections. Don't know where I go from here since now, some years later, the alcohol in the gel is causing itching which is gradually getting worse even though I switch between the two sites.
Totally agree with the the recharge your life etc comments. Without the testosterone, life quickly goes downhill!
Well they cannot tell you have prostate cancer without a biopsy or some kind of like exam. It's your call. If you do have PC then in a few years you will have more to worry about than a biopsy.
We kinda got off topic above. Really what this is about is whether TRT increases the chance of cancer or not. It has been said that those that are low on testosterone have an increased risk of prostate cancer, but some believe that TRT will also increase the risk. really I don't think doctors know the answer to this. I am one that would rather not know about having cancer unless it is fixable and I remain functional. Also largely depends on the age of diagnosis. If I am 75 then I see no point in treating it as most likely I will die from heart disease first. It also depends on how aggressive the cancer is. So many factors make the decision complicated, but ultimately we all want to survive with A decent quality of life. The research on this is still poor and researchers are still looking for better ways to detect PC and figure out if it is the aggressive type or not. Until then we still have Biopsy and the human error factor. I hope that one day we can take PC off the table as a problem. It may be as simple as a vaccine.