Just had the biggest scare of my life (PSA = 10.6)!! Need some advice.

[Pacman]

In 6 months my total PSA went from 1.4 ng/dL to 10.6 ng/dL!

This freaked me out like crazy, especially since my dad passed away two years ago from prostate cancer and that was literally the exact way he found out that he had prostate cancer.

I am in my 30s. So a jump that high in just 6 months is very scary!!!

I immediately went and did another PSA test upon seeing these results, this time free+total just to get a more comprehensive picture, and the total was 7.4 ng/dL and free was 7.0 ng/dL!

So it did go down for whatever reason.

I set an appointment with a urologist right away as well.

He said that he doubts it is cancer, he believes it is some sort of infection. He decided not to do a prostate exam, because if it is an infection, manually examining the prostate would make it worse.

So I am on antibiotics for 2 weeks. Ciprofloxacin 500mg/twice daily. He said wait a week after the two weeks are up and take the PSA test again.

He also said not to inject testosterone at all, until my next visit to him, so I am 3 weeks now with no T (I figured if it is cancer, better not to inject, so I actually stopped injecting before I saw him). So if I wait until I see him, that will be 6 full weeks with no testosterone injections. Not something I am too happy about. He also said no biking!

A week into the antibiotic treatment, I just wanted the mental reassurance that it is working so I did a total PSA test for myself, and it came back exactly 4.0 ng/dL. Which is (the high end of) normal!!

So that basically proves it is not cancer right? If it was cancer, the PSA level wouldn't drop in response to antibiotics, correct? It's not possible for both to occur at the same time, correct?

I am just wondering if I can hop back on testosterone and skip the MRI for the prostate.

Does anyone here have some advice for me?

 

[Vtail]

1.4 to 4.0 is still a pretty big jump in just 6 months. Why not get the MRI for peace of mind?

 

[MIP1950]

It does seem like you have/had prostatitis, whether due to infection or localized inflammation. I've had high hsCRP levels, which indicates inflammation and my PSA keeps inching up, too. I also had severe dental problems,including infections, for which the only remedy was to have all my teeth extracted and eventually getting snap-in dentures. Last PSA was 4.95, so its been six weeks and going for another test. I'm hoping the removal of the teeth and antibiotic therapy will result in lower PSA...fingers crossed.

As for resuming testosterone, let your urologist give you the official okay. Also, let your doctor advise you as to whether you can forego the MRI.

 

[Arturo]

I'd get a biopsy just to be safe.

 

[Systemlord]

He also said not to inject testosterone at all, until my next visit to him, so I am 3 weeks now with no T (I figured if it is cancer, better not to inject, so I actually stopped injecting before I saw him). So if I wait until I see him, that will be 6 full weeks with no testosterone injections.

TRT doesn't fuel or cause prostate cancer, so make sure your doctor is up to date on current medical literature.

The last time I checked urologist aren't giving men with prostate cancer drugs to crash their natural testosterone levels for fear of testosterone worsing prostate cancer.

All that's needed is a little common sense.

 

[Pacman]

TRT doesn't fuel or cause prostate cancer, so make sure your doctor is up to date on current medical literature.

I really really hope this is true! Can you please provide me a source for this? Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief?

I really want to go back on TRT as soon as possible, even at a reduced dose if that is all I can do for now.

1.4 to 4.0 is still a pretty big jump in just 6 months. Why not get the MRI for peace of mind?

Yup, I decided to do this. And it jumped from 1.4 to 10.6 in 6 months. The 4.0 number is due to antibiotics. I canceled my previous MRI because I figured probably not needed. But then I realized that I won't have full peace of mind without an MRI confirmation that I do not have cancer. I figured that just because the chances are very low, doesn't mean impossible! I do not want to constantly be wondering if I made the mistake of my life by foregoing the MRI. Also, at the MRI place (I went to set an appointment in person) they told me either way it is a very good idea, because even if nothing bad appears in the MRI, we will have a baseline image, which is very useful in the diagnostic process and seeing progressions (if any) etc etc.

Going to do the MRI.

 

[Deleted member 16042]

urologist aren't giving men with prostate cancer drugs to crash their natural testosterone levels for fear of testosterone worsing prostate cancer.

Huh?

Last time I looked (Last fall, when I had a followup prostate MRI based on PSA of 11.2) In mainstream prostate cancer treatment, ADT (Androgen Deprivation Therapy) remains one of the main weapons in the arsenal for treating prostate cancer. That does not pertain to the OP's circumstances at this time, unless diagnosed with hormone driven PCa.

It does not make much sense though to pause TRT in this context. The (low) level of T required to reduce hormone driven PCa to a controllable level is close to zero. Discontinuing TRT will not get you there in 6 weeks. Unless you have been physically castrated, It typically takes heavy duty ADT drugs to accomplish this.

 

[madman]

I really really hope this is true! Can you please provide me a source for this? Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief?

I really want to go back on TRT as soon as possible, even at a reduced dose if that is all I can do for now.


Yup, I decided to do this. And it jumped from 1.4 to 10.6 in 6 months. The 4.0 number is due to antibiotics. I canceled my previous MRI because I figured probably not needed. But then I realized that I won't have full peace of mind without an MRI confirmation that I do not have cancer. I figured that just because the chances are very low, doesn't mean impossible! I do not want to constantly be wondering if I made the mistake of my life by foregoing the MRI. Also, at the MRI place (I went to set an appointment in person) they told me either way it is a very good idea, because even if nothing bad appears in the MRI, we will have a baseline image, which is very useful in the diagnostic process and seeing progressions (if any) etc etc.

Going to do the MRI.

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

Take-home point:

*Nonetheless, in the absence of large-scale, long-term controlled studies, it is impossible to definitively assert the safety of TTh with regard to PCa.




Recommendations on the diagnosis, treatment, and monitoring of testosterone deficiency in men (2021)

Bruno Lunenfeld, George Mskhalaya, Michael Zitzmann, Giovanni Corona,
Stefan Arver, Svetlana Kalinchenko, Yuliya Tishova & Abraham Morgentaler



PCa

*There is no evidence of increased PCa risk in men on TTh

*Recent evidence fails to support the longstanding fear that T therapy will increase prostate cancer risk or cause rapid growth of occult cancer

*The relationship between testosterone and prostate cancer appears to follow a saturation curve, present in many biological systems, in which growth corresponds with a concentration of a key nutrient until a concentration is reached in which an excess of the nutrient is achieved (Figure 2). Clinical data indicate the saturation point for serum T is approximately 250 ng/dL (8.68 nmol/L)

*There is no evidence that TTh will convert sub-clinical prostatic lesions to clinically detectable PCa

*Nonetheless, in the absence of large-scale, long-term controlled studies, it is impossible to definitively assert the safety of TTh with regard to PCa.

*Therefore, prior to starting TTh, a patient’s risk of PCa must be assessed using, at a minimum measurement of serum prostate-specific antigen (PSA). Pretreatment assessment should include PCa risk predictors such as age, family history of PCa, and ethnicity/race. If suspicion of PCa exists, it may be reasonable to perform a prostate biopsy if warranted by clinical presentation. Testosterone therapy may be initiated in these men if a prostate biopsy is negative

*After initiation of TTh, patients should be monitored for prostate disease with measurement of serum PSA at 3–6 months, 12 months, and at least annually thereafter. In a subject with an increased risk of PCa urologist supervision is required

*An initial increase of prostate-specific antigen (PSA) and prostate volume with TTh is frequently seen over the first 2–6 months because the prostate is an androgen-dependent organ. The increase in PSA will be greatest in men with marked TD and least (or absent) in men with milder degrees of TD. The PSA level at 6 months after initiation of TTh should be used as the new baseline

*Referral to a urologist for prostate evaluation and possible biopsy during TTh should be made with the development of a new palpable prostate abnormality on DRE or with a worrisome rise in PSA. Recommendations regarding what constitutes a concerning rise in PSA include an increase of 1.0 ng/ml over baseline PSA or a PSA velocity greater than 0.35 ng/ml per year

Innovations in Testosterone Therapy in Men Treated for Prostate Cancer

Urology Times® is celebrating its 50th anniversary in 2022. To mark the occasion, we are highlighting 50 of the top innovations and developments that have transformed the field of urology over the past 50 years. In this installment, Amy Pearlman, MD, interviews Mohit Khera, MD, MBA, MPH on how...

www.excelmale.com

Testosterone use in Prostate Cancer

Testosterone use in Prostate Cancer by Dr. Luke Witherspoon, MSc, MB, MD; Sexual and Reproductive Medicine Fellow, University of British Columbia; Functional Urology Research Fellow, University of Ottawa

www.excelmale.com

Is it safe to prescribe supplemental T for PCa patients with hypogonadism?

CASE PRESENTATION A 64-year-old healthy man presented with prostate cancer diagnosed in 2016. The pathology showed Gleason scores 3+3 and 3+4 in multiple cores and the patient underwent an uncomplicated radical prostatectomy. He regained urinary continence; however, he required injection...

www.excelmale.com

TRT in Men with Biochemical Recurrence and Metastatic Prostate Cancer

Abraham Morgentaler, MD, FACS, summarizes results from a study on testosterone therapy for patients with advanced prostate cancer.

www.excelmale.com

Testosterone Mythology Debunked

We live in a polemic world of clashing misinformation. Especially about hormones. Including testosterone. Too many men are taken off Testosterone (T) if they get a diagnosis of prostate cancer or heart disease even though the science shows otherwise. Today’s interview is with Dr. Abraham...

www.excelmale.com

Impact of raising testosterone levels in men after radical prostatectomy

https://www.urologytimes.com/view/impact-of-raising-testosterone-levels-in-men-after-radical-prostatectomy A “testosterone challenge” approach appears to allow for early detection of prostate cancer recurrence in men with low testosterone after radical prostatectomy (RP), according to a study...

www.excelmale.com

Testosterone and Prostate Effects

7.1 Introduction Historically, testosterone (T) was thought to be involved in negative prostate events such as the growth of benign or malignant prostate tissue. This notion stems from the seminal 1941 article by Huggins and Hodges, which demonstrated that in men with metastatic prostate cancer...

www.excelmale.com

TRT and prostate cancer

Introduction: It has been well established that male hypogonadism has a significant impact on patient quality of life and that replacement of testosterone can markedly improve symptoms and potentially offer a protective effect. The connection between testosterone replacement therapy (TRT) and...

www.excelmale.com

TTh in Men with Biochemical Recurrence and Metastatic PCa

Abstract Introduction: Although prostate cancer (PCa) has long been considered an absolute contraindication for testosterone therapy (TTh), growing literature suggests TTh may be safely offered to men with localized PCa. We here present a single-center series of men treated with TTh for relief...

www.excelmale.com

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

Trends in Testosterone Therapy use in PCa Survivors in the United States

ABSTRACT Background: Physician prescribing patterns surrounding the use of testosterone therapy (TTh) in men with a history of prostate cancer (CaP) is not well described. Aim: To characterize the demographics and usage patterns of testosterone therapy in men with a history of prostate cancer...

www.excelmale.com

Androgen Society 3rd Annual Meeting Review (Day 2)

Androgen Society 3rd Annual Meeting Review (Day 2) – Summary: Abraham Morgentaler, MD, FACS, Associate Clinical Professor of Urologic Surgery at Harvard University, reviews the second day of the 3rd annual meeting of the Androgen Society, an international organization consisting of healthcare...

www.excelmale.com

Testosterone Therapy After Prostate Cancer Treatment: A Review of Literature

ABSTRACT Introduction: Although testosterone therapy (TTh) is the standard practice in otherwise healthy hypogonadal men, this therapy has historically been contraindicated in men with a history of prostate cancer. Recent evidence suggests that there is minimal or no prostate cancer growth in...

www.excelmale.com

The role of androgen therapy in prostate cancer: from TRT to BAT

Testosterone replacement therapy (TRT) is the primary treatment for male testosterone deficiency. This therapy raises concerns over the risk of prostate cancer (PC) because testosterone has historically been considered the fuel for PC. We discuss the re-evaluation of the relationship between...

www.excelmale.com

TRT in the Setting of Prostate Cancer

Abstract Since the 1940s, elevated serum testosterone (T) levels have been infamously suggested as a causal factor in the development of prostate cancer (PCa); this time was also the dawn of both surgically and pharmacologically induced castration. However, men suffering from primary or...

www.excelmale.com

Controversies in Testosterone Replacement Therapy (TRT)

Controversies in Testosterone Therapy ABSTRACT Introduction: Testosterone prescriptions have increased dramatically in recent years, largely because of changes in expert guidelines. Concerns have been raised that testosterone therapy (TTh) may be associated with an increased incidence of...

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Neglected side effects to curative prostate cancer treatments

Neglected side effects to curative prostate cancer treatments Alexander B. Nolsøe ● Christian Fuglesang S. Jensen ● Peter B. Østergren ● Mikkel Fode Abstract In this narrative review, we summarize the neglected side effects of curative intended treatment for prostate cancer. They include...

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Treatment of nonmetastatic castration-resistant prostate cancer

Abstract Background Nonmetastatic castration-resistant prostate cancer (nmCRPC) is defined as a rising prostate-specific antigen concentration, despite castrate levels of testosterone with ongoing androgen-deprivation therapy or orchiectomy, and no detectable metastases by conventional imaging...

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Hypogonadism and its treatment among prostate cancer survivors

Hypogonadism and its treatment among prostate cancer survivors Edward J. Choi ● Perry Xu ● Farouk M. el-Khatib ● Linda M. Huynh ● Faysal A. Yaf Abstract Adult-onset hypogonadism (AOH) is associated with sexual dysfunction, poor bone mineralization, decreased muscle mass, metabolic...

www.excelmale.com

Management of TRT Complications: Panel Discussion

AUA Live Panel Discusses Management of Testosterone Therapy Complications Since the start of the century, there has been an exponential rise in testosterone replacement therapy prescribing. The diagnosis and management of hypogonadism continue to constitute a significant portion of many...

www.excelmale.com

TRT and prostate cancer

Introduction: It has been well established that male hypogonadism has a significant impact on patient quality of life and that replacement of testosterone can markedly improve symptoms and potentially offer a protective effect. The connection between testosterone replacement therapy (TRT) and...

www.excelmale.com

PSA Concentrations in Response to T Treatment of Severely Hypogonadal Men

Abstract Context: Clinical guidelines recommend measurement of the serum prostate-specific antigen (PSA) concentration during testosterone treatment of hypogonadal men to determine whether the increase is sufficiently high to warrant urologic referral. Prior studies of the effect of...

www.excelmale.com

Strategies for T Therapy in Men with Metastatic Prostate Cancer in Clinical Practice

Abstract Purpose: To investigate prostate-specific antigen (PSA) and clinical responses to a variety of treatment strategies involving testosterone therapy (TTh) in men with metastatic prostate cancer (mPCa). Materials and Methods: Case records were reviewed for three men with advanced PCa...

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TRT Use in Men After Prostatectomy is Safe

Oncological safety and functional outcomes of testosterone replacement therapy in symptomatic adult‑onset hypogonadal prostate cancer patients following robot‑assisted radical prostatectomy Abstract Purpose Testosterone replacement therapy (TRT) remains controversial in men with treated...

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Testosterone and prostate health

Testosterone and prostate health: Have the paradigms truly shifted? The concept that testosterone (T) promotes the growth of prostate cancer (PCa) was firmly established around the middle of the last century, based initially on animal and human studies entirely appropriate for the...

www.excelmale.com

Paying the price for standing tall: Fluid mechanics of prostate pathology

Abstract Background: Age‐dependent increase in the incidence of benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are both related to cell proliferation and survival controlled by intraprostatic free testosterone (FT) concentration. Paradoxically, BPH and PCa occur as circulating...

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Controversies with testosterone therapy

Controversies with testosterone therapy Mohit Khera, MD Department of Urology, Baylor College of Medicine, Houston, Texas, USA Introduction: Over the past decade, there have been concerns with the safety of testosterone therapy (TTh) in hypogonadal men. Several concerns have centered on the...

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Questioning the evidence behind the Saturation Model for TRT in prostate cancer

Letter to the editor: Questioning the evidence behind the Saturation Model for testosterone replacement therapy in prostate cancer Abraham Morgentaler , Abdulmaged M. Traish To the editor: We are honored by Dr. Kim’s detailed review [1] of our paper, titled, “Shifting the paradigm of...

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ABE MORGENTALER TALKS ABOUT MEN’S HEALTH, SEX DRIVE AND THE BENEFITS OF TESTOSTERONE THERAPY

EPISODE 103: ABE MORGENTALER TALKS ABOUT MEN’S HEALTH, SEX DRIVE AND THE BENEFITS OF TESTOSTERONE THERAPY // Feb 18, 2020 @Mountain Man PODCAST (roughly 2 hrs) IHMC STEM-Talk with Abe Morgentaler Today’s interview is with Dr. Abraham Morgentaler, an internationally known pioneer in...

www.excelmale.com

 

[MIP1950]

Huh?

Last time I looked (Last fall, when I had a followup prostate MRI based on PSA of 11.2) In mainstream prostate cancer treatment, ADT (Androgen Deprivation Therapy) remains one of the main weapons in the arsenal for treating prostate cancer. That does not pertain to the OP's circumstances at this time, unless diagnosed with hormone driven PCa.

It does not make much sense though to pause TRT in this context. The (low) level of T required to reduce hormone driven PCa to a controllable level is close to zero. Discontinuing TRT will not get you there in 6 weeks. Unless you have been physically castrated, It typically takes heavy duty ADT drugs to accomplish this.

There's an interview on excelmale from @madman, I believe, with Dr. Abraham Morgentaler, urologist/TRT expert at Harvard who is one of the cutting edge doctors in the world, including that testosterone not always contradicted in PCa.

 

[Systemlord]

Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief

There was never any proof that high testosterone or TRT fueled, caused prostate cancer, it was a belief.

They used to believe low testosterone was prostate friendly, until data starting coming in that showed men with low T having more aggressive forms of prostate cancer compared with those with high testosterone.

Testosterone replacement and prostate cancer - PMC

This article is intended as a review of the available clinical data outlining the risks and benefits of testosterone (androgen) replacement therapy, specifically addressing the issue of the relationship between exogenous androgen administration and ...

www.ncbi.nlm.nih.gov

Several studies have been conducted to analyze the impact of testosterone replacement on PSA. Except for a rise in PSA shortly after initiating testosterone therapy, there is no increased risk of developing prostate cancer while on testosterone replacement therapy.

Testosterone Therapy in Men With Prostate Cancer - PMC

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of ...

www.ncbi.nlm.nih.gov

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of testosterone deficiency in men with prostate cancer.

 

[madman]

I really really hope this is true! Can you please provide me a source for this? Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief?

I really want to go back on TRT as soon as possible, even at a reduced dose if that is all I can do for now.


Yup, I decided to do this. And it jumped from 1.4 to 10.6 in 6 months. The 4.0 number is due to antibiotics. I canceled my previous MRI because I figured probably not needed. But then I realized that I won't have full peace of mind without an MRI confirmation that I do not have cancer. I figured that just because the chances are very low, doesn't mean impossible! I do not want to constantly be wondering if I made the mistake of my life by foregoing the MRI. Also, at the MRI place (I went to set an appointment in person) they told me either way it is a very good idea, because even if nothing bad appears in the MRI, we will have a baseline image, which is very useful in the diagnostic process and seeing progressions (if any) etc etc.

Going to do the MRI.

*Therefore, prior to starting TTh, a patient’s risk of PCa must be assessed using, at a minimum measurement of serum prostate-specific antigen (PSA). Pretreatment assessment should include PCa risk predictors such as age, family history of PCa, and ethnicity/race. If suspicion of PCa exists, it may be reasonable to perform a prostate biopsy if warranted by clinical presentation. Testosterone therapy may be initiated in these men if a prostate biopsy is negative

*After initiation of TTh, patients should be monitored for prostate disease with measurement of serum PSA at 3–6 months, 12 months, and at least annually thereafter. In a subject with an increased risk of PCa urologist supervision is required

*An initial increase of prostate-specific antigen (PSA) and prostate volume with TTh is frequently seen over the first 2–6 months because the prostate is an androgen-dependent organ. The increase in PSA will be greatest in men with marked TD and least (or absent) in men with milder degrees of TD. The PSA level at 6 months after initiation of TTh should be used as the new baseline

*Referral to a urologist for prostate evaluation and possible biopsy during TTh should be made with the development of a new palpable prostate abnormality on DRE or with a worrisome rise in PSA. Recommendations regarding what constitutes a concerning rise in PSA include an increase of 1.0 ng/ml over baseline PSA or a PSA velocity greater than 0.35 ng/ml per year

Beyond PSA: New Prostate Cancer Screening Options

Prostate-specific antigen (PSA) is one of the best-known biomarkers for screening, diagnosis, and follow-up of patients for prostate cancer. Owing to several inherent limitations with PSA, various newer blood and urinary-based biomarkers have been evaluated in pursuit of better detection and...

www.excelmale.com

Biochemical and Genomic Markers for Prostate Cancer

Abstract Purpose: Detecting prostate cancer, developing therapeutic plans after negative biopsies, and prognosis-based patient counseling can be challenging for many urologists dealing with prostate cancer-specific antigens. New Biomarkers advances made improvements for the prediction of...

www.excelmale.com

Prostate Cancer Early Detection

Peter R. Carroll, MD, MPH, discusses guidelines and research on prostate cancer early detection and ways to avoid unnecessary biopsies.

www.excelmale.com

Testosterone Recovery Profiles after Cessation of Androgen Deprivation for Prostate Cancer

John P. Mulhall, MD, discusses the significant sexual and non-sexual adverse events of low testosterone resulting from using androgen deprivation therapy (ADT) to treat men with prostate cancer. He emphasizes the need for physicians to counsel patients on long-term expectations and to obtain...

www.excelmale.com

Next Generation Imaging for Prostate Cancer

Phillip J. Koo, MD, gives an overview of the current state of next-generation imaging for prostate cancer and how it compares to conventional imaging.

www.excelmale.com

Incorporating MRI for Early Prostate Cancer Detection

Screening and Prevention of Prostate Cancer 2021 (Part 3): Incorporating MRI for Early Detection – Summary: In the final part of a 3-part series, Sigrid V. Carlsson, MD, Ph.D., MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, considers the current role of MRI...

www.excelmale.com

Who Needs a Prostate Biopsy?

Screening and Prevention of Prostate Cancer 2021 (Part 2): Who Needs a Biopsy? – Summary: In part 2 of a 3-part series, Sigrid V. Carlsson, MD, Ph.D., MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, goes over her 5 Golden Rules for prostate cancer testing...

www.excelmale.com

Evidence for PSA Screening

Screening and Prevention of Prostate Cancer 2021 (Part 1): Evidence for PSA Screening – Summary: In part 1 of a 3-part series, Sigrid V. Carlsson, MD, Ph.D., MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, looks at the evidence supporting widespread...

www.excelmale.com

MRI-US fusion guided prostate biopsy

Abstract Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy have become the standard for prostate cancer diagnosis. As their implementation is relatively recent, experience is still limited in various centers. An MRI-guided biopsy requires basic knowledge in...

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Incidental findings in and around the prostate on prostate MRI

Abstract Prostate MRI has seen rapid growth in use in recent years as an advanced diagnostic modality to detect focal areas of clinically significant prostate cancer, identify an area for targeted biopsy, and guide management and surveillance. The increase in use has also led to increased...

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Prostate Cancer Biomarker Development

Prostate Cancer Biomarker Development: National Cancer Institute’s Early Detection Research Network Prostate Cancer Collaborative Group Review ABSTRACT Prostate cancer remains the most common non-skin cancer and the second leading cause of death among men in the United States. Although...

www.excelmale.com

 

[madman]

I really really hope this is true! Can you please provide me a source for this? Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief?

I really want to go back on TRT as soon as possible, even at a reduced dose if that is all I can do for now.


Yup, I decided to do this. And it jumped from 1.4 to 10.6 in 6 months. The 4.0 number is due to antibiotics. I canceled my previous MRI because I figured probably not needed. But then I realized that I won't have full peace of mind without an MRI confirmation that I do not have cancer. I figured that just because the chances are very low, doesn't mean impossible! I do not want to constantly be wondering if I made the mistake of my life by foregoing the MRI. Also, at the MRI place (I went to set an appointment in person) they told me either way it is a very good idea, because even if nothing bad appears in the MRI, we will have a baseline image, which is very useful in the diagnostic process and seeing progressions (if any) etc etc.

Going to do the MRI.

Look this over!

Who Needs a Prostate Biopsy?

Screening and Prevention of Prostate Cancer 2021 (Part 2): Who Needs a Biopsy? – Summary: In part 2 of a 3-part series, Sigrid V. Carlsson, MD, Ph.D., MPH, Assistant Attending Epidemiologist at Memorial Sloan Kettering Cancer Center, goes over her 5 Golden Rules for prostate cancer testing...

www.excelmale.com

 

[madman]

I really really hope this is true! Can you please provide me a source for this? Why did everyone used to believe that testosterone makes things worse for an enlarged prostate and/or prostate cancer, and what changed their minds to completely reverse that belief?

I really want to go back on TRT as soon as possible, even at a reduced dose if that is all I can do for now.


Yup, I decided to do this. And it jumped from 1.4 to 10.6 in 6 months. The 4.0 number is due to antibiotics. I canceled my previous MRI because I figured probably not needed. But then I realized that I won't have full peace of mind without an MRI confirmation that I do not have cancer. I figured that just because the chances are very low, doesn't mean impossible! I do not want to constantly be wondering if I made the mistake of my life by foregoing the MRI. Also, at the MRI place (I went to set an appointment in person) they told me either way it is a very good idea, because even if nothing bad appears in the MRI, we will have a baseline image, which is very useful in the diagnostic process and seeing progressions (if any) etc etc.

Going to do the MRI.

This is gold!

Testosterone Mythology Debunked

We live in a polemic world of clashing misinformation. Especially about hormones. Including testosterone. Too many men are taken off Testosterone (T) if they get a diagnosis of prostate cancer or heart disease even though the science shows otherwise. Today’s interview is with Dr. Abraham...

www.excelmale.com

In this show you will learn:


• That T does NOT drive prostate cancer.

• How this myth started and has incorrectly affected medicine for 80 years.

• The known and unknown symptoms of low T.

• The issue with just looking at total testosterone and why you must run “free testosterone” and also “SHBG”.

• What do lizards and men have in common?

• The unappreciated role of hormones in overall health and why so often our doctors don’t realize this or take this into consideration when treating us

 

[madman]

There was never any proof that high testosterone or TRT fueled, caused prostate cancer, it was a belief.

They used to believe low testosterone was prostate friendly, until data starting coming in that showed men with low T having more aggressive forms of prostate cancer compared with those with high testosterone.

Testosterone replacement and prostate cancer - PMC

This article is intended as a review of the available clinical data outlining the risks and benefits of testosterone (androgen) replacement therapy, specifically addressing the issue of the relationship between exogenous androgen administration and ...

www.ncbi.nlm.nih.gov

Several studies have been conducted to analyze the impact of testosterone replacement on PSA. Except for a rise in PSA shortly after initiating testosterone therapy, there is no increased risk of developing prostate cancer while on testosterone replacement therapy.

Testosterone Therapy in Men With Prostate Cancer - PMC

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of ...

www.ncbi.nlm.nih.gov

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of testosterone deficiency in men with prostate cancer.

Library of webinars/lectures and studies on here.

Just use the search function.

Yet you are digging up crumbs!

 

[Deleted member 16042]

There's an interview on excelmale from @madman, I believe, with Dr. Abraham Morgentaler, urologist/TRT expert at Harvard who is one of the cutting edge doctors in the world, including that testosterone not always contradicted in PCa.

Sorry that my main point regarding the OP was apparently obscure:

(ADT) does not pertain to the OP's circumstances at this time

It does not make much sense... to pause TRT in this context.

I've been a fan of Morgantaler and his work for years, does this outlook not reflect that?

The rest of my commentary pertains to the use of ADT for treating hormone sensitive PCa. Sorry if that muddied the water. My response to Systemlord was because urologists DO use ADT in treating prostate cancer. It remains one of the preferred methods of treatment for androgen sensitive prostate cancers. Though related, the use of ADT is different topic than the debunked controversy over exogenous testosterone use as a contributor to PCa.

 

[Pacman]

Wow thank you all for your responses! And @madman thank you especially for linking all those links!! I have a lot to read and catch up on.

So far I watched the interview with Dr. Abraham Morgentaler, fascinating interview. It's outrageous that the medical consensus was based off of one study that was based off of one person, and even that person did not show a direct causative link between testosterone and prostate cancer!!

And did I understand that right that the doctor who created that myth got a Nobel Prize for it?! That's very scary, considering that if someone gets a Nobel Prize for something, we are much less likely to question the scientific/medical conclusion of said recipient. So 80 years we have been living with that myth. Wow.

It was strange that the study was not linked in the video interview, but I did some Googling and I believe I found it (please correct me if this is the wrong study) -

PubMed link: Testosterone Therapy and Prostate Cancer - PubMed
Sci-Hub link: Sci-Hub | Testosterone Therapy and Prostate Cancer | 10.1016/j.ucl.2016.01.007

As a side note, Sci-Hub is a VERY useful website! It gives you direct access to the full studies when PubMed and those other sites paywall them. Medical knowledge should NOT be paywalled, just my opinion. You just need to copy paste the URL of the study you want, and boom full access!!