What You Need to Know Before You Start
What Are the Risks and Benefits of Testosterone Replacement Therapy for Men With Prostate Cancer?
Figuring out the risks and rewards of testosterone replacement therapy (TRT) for men with prostate cancer can be complicated.
While many assume testosterone should be avoided at all costs due to potentially fueling cancer growth,the truth is far more nuanced. On one hand, TRT can improve recovery of erectile function following prostate cancer treatment because testosterone plays a key role in overall erectile health.
According to new research,this treatment may actually reduce the risk of aggressive prostate cancer thanks to protecting healthy androgen receptor signaling within prostate cells.
However,TRT is contraindicated in men with untreated prostate and breast cancer due to concerns about promoting cell growth that could lead to metastases or biochemical recurrence.
And patients with testosterone deficiency and a history of prostate cancer should be informed that there is inadequate evidence from prospective studies to quantify the risk-benefit ratio of testosterone therapy.
While current retrospective data has not shown an increased danger,larger randomized trials are needed.
In addition,some men may experience immediate side effects while on this hormone testosterone such as breathing disturbances during sleep ,breast swelling or tenderness.
Long-term risk for cardiovascular events in prostate cancer survivors on testosterone also remain unclear.
TRT can offer tangible benefits for men with symptomatic hypogonadism after cancer treatment. But caution should be exercised and potential drawbacks discussed openly with your doctor due to lacking definitive evidence from clinical trials in prostate cancer patients.
As always,a personalized approach focused on optimizing quality of life through close monitoring and communication better represents the standard of care.
How Is Testosterone Replacement Therapy Administered to Men With Prostate Cancer?
When it comes to administering testosterone replacement therapy (TRT) to men with prostate cancer, doctors have several options available depending on each patient’s situation.
One common method involves applying testosterone gel or creams to the shoulders or upper arms daily.
This topical therapy allows for non-invasive absorption of testosterone through the skin and into the bloodstream – an approach often preferred by patients for its convenience.
Another popular option involves testosterone injections into muscle or under the skin,typically administered in a doctor’s office every 1 to 4 weeks.
While requiring an external needle,injections typically provide steadier hormone levels compared to other forms of TRT.
Some urologists may also prescribe testosterone pellets that slowly release hormone over 3 to 6 months.These rice-sized implants are inserted just beneath the skin during an office procedure.Unlike other treatments,pellets offer continuous drug release and potentially fewer medical visits.
A lesser known approach utilizes buccal tablets that dissolve between the cheek and gums to deliver testosterone via the oral mucosa membranes and directly into the bloodstream.This method results in rapid absorption but requires multiple daily doses.
Regardless of the administration method chosen, urologists tend to be hesitant about prescribing TRT for men who’ve had definitive therapy for prostate cancer or those at high risk for new prostate cancer.
Close monitoring for potential adverse events like polycythemia and recurrence remains vital.
What Are the Guidelines for Administering Testosterone Replacement Therapy to Men With a History of Prostate Cancer?
Before prescribing testosterone replacement therapy (TRT) to men with a history of prostate cancer, doctors must consider several important guidelines:
First, TRT remains strictly contraindicated in men with untreated prostate or breast cancer due to concerns about worsening the underlying malignancy. The sole focus for these patients remains definitive treatment and control of their existing cancer.
Second,all patients on TRT require close monitoring for potential side effects, particularly polycythemia increases in red blood cell count that could heighten risk of stroke or heart attack. Regular blood work allows doctors to assess hormone levels, PSA values and any changes that may signal problems.
Additionally,the 2008 European Association of Urology (EAU) guidelines recommend testosterone replacement can be considered in men with symptomatic hypogonadism after successful prostate cancer treatment – provided there’s no evidence of recurrent disease during a “prudent interval” of observation.However,the optimal duration remains undefined.
The EAU guideline further stipulate that a high risk of developing prostate cancer should be viewed as a contraindication for TRT due to inadequate data supporting its safety in such patients.This includes men with a family history of early-onset prostate cancer,African ancestry or underlying genetic conditions that raise their baseline risk.
While TRT was historically avoided in all men with a history of prostate cancer due to “abundance of caution”, newer evidence now suggests that – with appropriate safeguards -administeringtestosterone can actually reduce the risk of aggressive prostate cancer development, especially when levels are normalized.
FAQs About Testosterone Therapy for Prostate Cancer
Should testosterone replacement therapy be avoided completely for advanced prostate cancer?
Androgen deprivation therapy through surgical or medical castration remains the standard treatment for advanced or metastatic prostate cancer.
However, some recent clinical trials suggest that a bipolar androgen therapy approach using intermittent testosterone treatment may actually improve outcomes for castration-resistant disease.
Further research is needed before recommending this approach generally for advanced prostate cancer patients.
How does testosterone therapy affect prostate cancer cells?
Most prostate cancer cells depend on androgen hormones like testosterone to stimulate growth and progression. That’s why androgen deprivation therapy is so effective in advanced cases.
However, some prostate cancer cells can become resistant to hormonal therapy over time, evolving into castration-resistant prostate cancer that tends to be far more aggressive.
What are the types of hormone therapy for prostate cancer?
Main types include androgen deprivation therapy, anti-androgens and bipolar androgen therapy. Androgen deprivation involves surgical or medical castration to lower testosterone to very low levels.
Anti-androgens block androgens from binding to receptors. Bipolar androgen therapy uses intermittent periods of androgen suppression and testosterone replacement.
How does hormone therapy affect bone density?
A: Androgen deprivation therapy used as the primary treatment for prostate cancer can lead to rapid bone loss and increase risk of osteoporosis and fractures.
This effect occurs because testosterone helps maintain bone mass. Several medications can help mitigate impact on bone density during androgen deprivation but periodic bone density scans are advised.
What are common side effects of hormone therapy for prostate cancer?
Common side effects may include hot flashes, fatigue, weight gain, loss of muscle mass and strength, reduced libido and sexual function, anemia, mood changes and increases in blood sugar and cholesterol levels. Side effects vary from patient to patient and some are more bothersome than others.
Have You Undergone Treatment for Prostate Cancer but Still Struggle With Symptoms of Low Testosterone?
The experts at Physicians Rejuvenation Centers (PRC) can help determine if testosterone optimization through hormone replacement therapy is right for you – in a safe and effective manner.
Reclaiming your vitality – while preserving your health.
Speak with one of our specialists today.
Call Physicians Rejuvenation Centers at 561-783-5153 or book your consultation here. Let’s work together towards reclaiming your vitality — in a safe, effective manner.
