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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2006

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Test replacement, ejac. volume, prostate

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anon@anon.it - 17 Jun 2004 03:35 GMT
Hello, two questions. One is gonna get graphic but I don't see the answer
on the net.
1. I am taking test replacement. I am 35 and have hypogonadism due to a
pituitary tumor. My Dr. constantly warns me about the correlation between
free T and prostate cancer. One week ago, a friend was diagnosed with
prostate cancer so now I'm _paranoid_. I want a satisfactory life...
without T, I have severe concentration problems, irritability, and
erection problems. However, from what I know, T replacement doesn't
_cause_ prostate cancer, it can just accelrate it IF it's there. Right?
My PSA is below 1 and I have been having DRE's for as long as I have had
T replacement, 33. My doc would love to see me off of T, but it's hard to
communicate what life is like without it to him. Serious question: is it
foolish of me to want to continue replacement (w/o it, my bound T will go
to 50 and total will drop to below 200) and HOPE that I never get cancer?
I'd rather have a normal life now than suffer from 35 onward to prevent
something that might not even happen.

2. The embarassing question. Ever since I can recall, I have had VERY
large  orgasms. My ejaculatory volume is typically in the two to three
tablespoon (not teaspoon) range, and there have been occasions where it's
been far, far more (though not often). Simple question: if I see a drop
in quantity significantly and _suddenly_, is this an indicator that I may
have prostate problems that I can't feel? I can't find any answers about
this--net searches only turn up info on porn stars (oh, great). Also, is
having such volume a sign of a larger than normal prostate? This has been
my condition since the onset of puberty.

I know I'm being overly panicked considering my friend's recent
diagnosis, but if anyone can give some consideration to these, that would
be appreciated...

Please post here, thx
gothika - 18 Jun 2004 06:26 GMT
>Hello, two questions. One is gonna get graphic but I don't see the answer
>on the net.
[quoted text clipped - 12 lines]
>I'd rather have a normal life now than suffer from 35 onward to prevent
>something that might not even happen.
Doctors can be real pains at times, especially in regards to
testosterone therapy.(You can be sure any doctor that suffers from
ailments requiring test injections damn sure take it themselves.)
The real problem is the law. Test is on the class A felony controlled
substance list, therefore doctors have to go through lengthy paperwork
and scrutiny if they prescribe it. Most refuse to treat patients that
require testosterone supplementation just to avoid dealing with the
DEA.
Pathetic to say the least.
sounds like your Dr. doesn't care if you have normal sexual function
or not.(a prevelant attitude I've found. The medical opinion is that
Sex is the only biological function that's purely voluntary, therefore
you shouldn't bitch if you doctor decides that you don't need to have
it anymore.
The issue of Test causing cancer is debateable at best. Virtually all
clinical studies have yet to conclusively prove that test alone causes
cancer.
Most who contract cancers are genetically predisposed in the first
place.
Testosterone does accelerate many bodily functions, i.e makes the
bodily endocrine functions function much as they did earlier in life.
This depends much on the dose rate and cycles though.
It'd take very high doses to put a strain on critical bodily
functions.
Certainly more than it takes to achieve the desired benefits from
test.(used to be that athletes that self-dosed used the "more is
better" philosophy. Clinical studies showed that "stacking" and
mega-dosing only curtailed natural test production with virtually no
muscle gains past the 1-2 cc dose rates.)
If you've made the decision to risk any possible cancer risks in order
to have test than your Dr. should be sympathetic. After all most men
would rather have some sexual function etc... than a long life with
none.
You're PSA's are quite low, my are typically around 3 and my doctors
don't panic over it.(Trus showed a smaller than normal prostate for my
age range, just alot of calcifications.)
There are other, more conclusive tests that'll rule out any possible
cancer. Have you doctor run them if he's wanting to stop your test
injections out of his fears of cancer.
As I've said in an earlier post, virtually all the pro athletes I've
known over the years are healthy as horses and much stronger than many
half their age.(My father was a power lifter and played football for
army way back in the 30's. when he died in his late 60's he was
married to a woman barely past 30. He exercised strenously most of his
life and was stronger than most men half his age. He didn't use test,
but was lucky to have a very high output of natural testosterone,
something I inherited to a lesser degree.)
I know they took test on a regular basis, some way too much.
Yet I don't know of one who contracted cancer or suffered any bad side
effects.(Many are like my dad, married to women much younger, some are
still fathering children. Even into their 60's etc...)
Consider the fact that in the 60's/70's these guys were taking the
harsh stuff too. DES and Hormone II, the rawest of Dianabol or even
class B anabolics.
You'd most likely be on Anathate or Ciprionate. A very close synthetic
match to regular male test.

>2. The embarassing question. Ever since I can recall, I have had VERY
>large  orgasms. My ejaculatory volume is typically in the two to three
[quoted text clipped - 5 lines]
>having such volume a sign of a larger than normal prostate? This has been
>my condition since the onset of puberty.

Large ejaculate volume is nothing unusual, I had enormous output most
of my active sex life.(I was precocious, hitting functional puberty at
11 and becoming sexually active with partners at 12. Had 3 marriages
and was very active sexually up until my late 40's when my problems
started.)
Seeing a drop in volume is one of the signs of either health problems
or advancing age. The size of the prostate has little to do with
volume, in fact it seems to follow an inverse rule.(The prostate  is
smaller in youth, yet puts out greater volumes. As it never stops
growing over one's lifetime is larger in later years, yet typically
secretes less volume.)
If it's a symptom of medical problems only a doctor and the right
tests will confirm.

>I know I'm being overly panicked considering my friend's recent
>diagnosis, but if anyone can give some consideration to these, that would
>be appreciated...
>
>Please post here, thx
George - 21 Jun 2004 06:00 GMT
Hi,  I had testosterone replacement therapy for several years before
my doctor found that I had prostate cancer. Athough the doctor had
prescribed the treatment and told me of the risks, she felt that it
was worth the risk because of my worsening situation of always feeling
like I had the flu and having something akin to hot flashes. With me
it was just feeling uncomfortably hot, especially in my face.

One day I found that I had stinging when I urinated. I went to the
doctor and, yes, a urinary infection was found that was cured with
antibiotics. At the same time my PSA was measured at 8.5 or so. The
doctor had been monitoring for years and this was the first time it
jumped up.  Biopsies confirmed that I did have prostate cancer. I was
about 65, so that is not too unusual even though there was no history
of any cancer in my family.  I was immediately taken off testosterone
supplements.

I had a prostectomy and after having the prostate removed the
pathologist reported that the cancer was more advanced than the biopsy
showed. However, the doctors involved concluded the cancer had not
matastised. A year afterwards though the PSA went up to about 3.5 and
then the next test it was back down to about 1.  Apparently there may
be some cancer hanging around inside my body, probably in microscopic
amounts.

Tonight I got on this site to seek out more information about taking
testosterone replacements. All the old symptoms have returned and
furthermore I am clinically depressed and have no energy to do most
thinks. I am told to exercise to feel better, but I cannot make myself
do the work. I often will sleep for up to 16 hours and sometimes will
not leave the house for days, living alone makes this possible.  For
this, recently, I have had anti depressant medicine increased. The
first weekend was right now and I was inside for 3 days and slept most
of Saturday and then 16 hours on Sunday.

I would love to try testosterone therapy again, but am sure no good
doctor will prescribe the medicine as the risk of speeding up whatever
cancer may be still there and having it show up in other parts of my
body are too great.

With that long story, I hope you might think about the risk you are
taking. If the testosterone does really make a difference in your
younger years I can see why you, like myself, would take that track. I
believe that the doctor has your best interests at heart. Ask him/her
to make sure to check your PSA every six months if there is a risk of
prostate cancer or you are afraid there is one.  You are young for a
rectal exam, but I believe the usual frequency is once per year. You
can also have a colonoscopy every 5 to 10 years.

One good thing is that if you do get prostate cancer for any reason,
it is better to catch it early with a PSA test and at a young age when
you can tolerate surgery.  New laproscopic surgery is making headway
in the USA (after the French used it for years) and that surgery can
be much less invasive and maintain your sexual functioning with nerve
sparing.

Good luck and keep healthy.

George

> >Hello, two questions. One is gonna get graphic but I don't see the answer
> >on the net.
[quoted text clipped - 98 lines]
> >
> >Please post here, thx
Ed Friedman - 24 Jun 2004 19:42 GMT
> Hi,  I had testosterone replacement therapy for several years before
> I would love to try testosterone therapy again, but am sure no good
> doctor will prescribe the medicine as the risk of speeding up whatever
> cancer may be still there and having it show up in other parts of my
> body are too great.

It all comes down to finding a doctor who knows what he is doing.  Check
out:   http://www.prostatepointers.org/prostate/leibowitz/HDTRT8.html

Ed Friedman
Samantha - 15 Jan 2006 07:59 GMT
Viagra and Prostate Cancer (ED treatments, erectile dysfunction and prostate)

Men with prostate cancer who have their prostate removed are usually free of
cancer, but the procedure often comes with a cost -- impotence. A new study,
however, shows that Viagra (sildenafil), the popular medication for erectile
dysfunction, can restore impotency lost in surgery. Whether men respond,
however, depends on how much nerve damage occurred during surgery.
Each year some 200,000 men are diagnosed with prostate cancer and, of those,
50,000 will have to undergo surgical removal of the prostate.

"Incontinence and impotence are the two most common [prostatectomy] side
effects. A large number of patients, even with nerve-sparing techniques, end
up with erectile dysfunction," Milton Lakin, MD, who leads the medical
urology section at Cleveland Clinic Foundation, tells WebMD. "The first thing
[doctors] want to do is a very good cancer operation. Cancers are being
discovered early enough that in many cases it is possible to spare both
nerves, or at least one."

The new study, which appears in the November Journal of Urology, was
completed by physicians at Baylor College of Medicine in Houston. It involved
about 80 men who ranged in age from 47 to 76 years old. All were prescribed
Viagra following prostate removal surgery. Based on their responses to a
series of questionnaires, 53% had improved erections and 40% had improved
ability to have intercourse.

Among those with nerves spared on both sides of the prostate, almost 60% had
improved erections and about 45% reported improvement in their ability to
have intercourse. Of men who had nerves spared on one side of the prostate,
close to 40% had improvement of their ability to have intercourse. For men
with no nerves spared, the reported increase in erections dropped to 20%,
with only 10% noting an improvement in the ability to have intercourse.

At least one side effect each was experienced by 63% of the men, most
commonly flushing, headache, nasal congestion, and heartburn.

Brian Miles, MD, one of the study authors, called the results "gratifying"
and noted that the findings indicate patients should start on the medication
about six months after surgery. He tells WebMD that he has had success with
nerve transfers that involve implanting a leg nerve in the pelvis, which can
help maintain normal erectile function.

These findings confirm previous study results and put a greater spotlight on
the prostate surgery itself, says Lakin, who was not involved in this study
but has been part of nearly identical studies that produced similar results.
"I am not a surgeon. I deal primarily with sexual dysfunction. But where I
think this [study] will have the most impact is in causing physicians to pay
more attention to nerve sparing," he says.

Lakin says that he commonly prescribes Viagra following surgery for prostate
cancer because other options are more invasive. "Unfortunately, it's very
hard not to offer a patient a pill even if their nerves have been cut, but I
am very honest with them. And if they call and say it didn't work, we go on
from there."

If Viagra fails, physicians can recommend other options, including injections
and vacuum devices, both of which have good success rates, even among men
whose nerves were damaged, according to Lakin.

Vital Information:

Viagra is an effective treatment for impotency in men who have their prostate
removed.
For men whose nerves have been spared, the drug improves the ability to have
an erection by nearly 60%, but the effectiveness drops to 20% in those with
no nerves spared.
There are other options for men who don't respond to Viagra, including
injections and vacuum devices.

Generic Viagra costs 80% less
http://www.mensgenerics.com/viagra.php

>Hello, two questions. One is gonna get graphic but I don't see the answer
>on the net.
[quoted text clipped - 28 lines]
>
>Please post here, thx

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