Having this going on now …have appointment for chat with doc about shots..need testosterone back…working out almost worthless…love you vids and the knowledge you share is great and really appreciated…thanks
Interesting that Dr. Sholtz mentions Lupron durations (4-6 mo. for intermediate risk and 12-18 mo. for high risk disease) that are a bit contradictory to a duration he mentioned in another recent video where he says he is revisiting these recommendations due to the advent/use of the PSMA test. A bit confusing for those of us trying to figure out how long to stay on ADT.
The following is a summary of my cancer as I understand it and is intended to create discussion on a treatment plan that explores options and includes shared decision making. I am a 67 year old male and I was diagnosed in March of 2022 with MRI biopsy that showed 11 of 12 cores positive mostly Gleason 6 and 7 but one Gleason 8 (4+4) and one Gleason 9 (4+5) both high percentage of core (80 percent). Had the whole body bone and pelvis scan which showed no metastasis, I kept pressing for a PSMA Pet Scan which one year ago wasn’t easy to get but my urologist thankfully agreed to ask Medicare and it was approved. The PSMA came back negative so no signs of spread on PSMA scan. My PSA never went above 10, I believe 9.5 was the highest it ever got so a slight positive I would think, but I do have high volume and high Gleason score disease. June 1st of 2022 I started Orgorvyx and had definitive Proton therapy for nine weeks (including the Seminal Vesicle and lymph nodes) then started Abiraterone mid September 2022. So I think I am one of the earliest patients to get a PSMA Pet Scan now approaching one year of ADT with Orgorvyx in June and September will be one year on Abiraterone. I know the protocols have not been worked out yet for people with High Risk Disease and a clear PSMA Pet Scan. My oncologist who I respect and am grateful to be under his care does not seem open to really entertaining the possibility of stopping the ADT early but my radiation doctor did say he thinks 1 to 2 years of ADT is sufficient, my oncologist thinks 2 years. I consider myself lucky to be getting good care and some of the latest treatments available. I promised myself I would give everything I got to cure the cancer but would not risk ruining my health with the ADT treatments. I am definitely following the advise about exercise, exercise, exercise and don’t want to damage my body more than necessary for a cure. So my PSA has been undetectable and I also have Natera ( Signatera) Genetic Residual disease testing done every 3 months which also comes back negative for any signs of disease. I feel that I am reaching the point where the cumulative effects of the ADT are becoming a big risk to my long term health and I am considering stopping the ADT at the end of August which will give me 15 months on Orgorvyx and 12 months on Abiraterone. I am presenting my case for a review as I am struggling with my decision to stop the ADT and need all the information I can get to make my choice. Thank you so much for your consideration.
Thanks for sharing; 70 underwent RT, placed under Zoladex for 8 mo, PSA & testosterone dropped from 46 & 6.7 to 0.8 & 0.3, respectively; feeling fatigued and lost muscles; oncologist gave me the option to stop ADT; my next visit I’ll ask for testosterone; quality of life matters to me.
Never make prostate cancer cells make their testosterone....cancer cells should not learn to make testosterone...... .supply little from outside in inj
I am stage 4 metastatic to bone in 4-5 locations, diagnosis in Feb of this year, no prior diagnosis or treatment and am currently about three months into ADT and finishing 6 Taxotere infusions in two weeks. Should I reasonably expect to be on hormone suppression indefinitely or might there be a scenario where after 18-24 months I might stop ADT for a while and allow my natural testosterone to come back up? I am younger, 57, and not experiencing problems with ADT side effects, I find them very manageable.
I had IMRT for nine weeks with no hormone therapy. My current testosterone level is 400. I am 66 years old, and I am a natural bodybuilder who is considering TRT. I desire to improve my libido and get more energy and build more muscle, but I am concerned about my prostate cancer returning. Do you recommend me consulting with my urologist or primary care physician about this issue?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I was on TRT for years before my PC DX this past November. My Dr.says TRT is a no-no and I am floundering. Asked him to check and testo was 278 and falling. My PSA has dropped as my testo dropped. My DX is Gleason 6 3+3 and it would seem reasonable for me to go back in TRT. I've never felt so bad. How do I convince my Dr.? My last TRT treatment was April of 2022.
Find a new doctor that understands PCa and testosterone. Yours doesn't. A Gleason 6 is not a contraindication for TRT. Taking testosterone would have no effect on your prostate based on the saturation model.
The weightlifting thing is one thing but the muscles that drive ejaculation and such, are tougher to maintain. Us married men have certain things expected of us and ADT is really making it tough.
Is it possible to get the citations for the studies that Dr. Scholz references in this video on testosterone replacement after radiation and hormone suppression therapy for prostate cancer in a moderate and high risk patient?
Great talk and thanks for the education you provided on this topic. Do you have any thoughts on testosterone replacement following robotic prostatectomy? Is it safe?
Thank you. Currently SEVEN months post LUPRON treatment (after two years of zero testosterone.) My prostectomy surgery removed BOTH my seminal and prostate glands. Right before surgery 411 was my testosterone. For seven months now my testosterone regenerated but kinda stopped at 200. Can I take DHEA, 25 or 50 or100mg daily?,
That's the problem finding anyone who will prescribe, they have so much old information, the medical professionals are still not up with current treatments, living in the past, scared to do anything that will give quality of life. It's the same for women too,if you have had cancer no way to get hormone therapy. Sometimes it's best to do whatever is right for you,be your own advocate,live your best life, chances are you will live as long with or without hormones it's just how you want to live the rest of your life.
I had prostate reduction but don't remember any prostate drugs verse. But since the surgery I have poor sleep quality. I can't take testosterone for the reasons stated in the video but is there an alternative that could help improve sleep or increase sleep?
Told I'm in remission after being diagnosed with stage 4 prostate C, and a PSA over 650. After chemo, and meds @ 65 years old, PSA is barely 1, but the restoration of some testosterone would likely reverse the process. Are steroids the continuous option to staying Cancer free. Thought processes remain cloudy and explained as chemo brain. Please, what are the correct questions I should be asking? Thank you in advance.
Can a PC patient has PSA of 28.5 while Gleason score per biopsy report is 3+3. A urologist said, if PSA is in 20s, Gleason score can't be 3+3, it should be higher so biopsy report can't be right or doctors missed something. Any thoughts please?
I just went through Cyber Knife two weeks ago and I was on TRT. I would like to keep talking TRT but my Urologist through the VA won’t let me. Can you give me any advice on finding another Urologist that will work with me on TRT. I have been on TRT since 2006 when I got back from Iraq and found out that I was not making enough testosterone on my own. I will be turning 64 this coming year.
What I want to know is if I stop hormone theropy will my terrible day long sweats stop? At 75 these day long sweats have made my lifestyle really not livable. My PSA is 0.75 and my prostate and lymph nodes have reduced in size.
Hello, We have a couple of videos that talk about that. This one is about side effects in general, but it mentions that possibility of using an estrogen patch or a few other medications that my help with hot flashes and long sweats. ruclips.net/video/efza9vq-cg8/видео.html We also have this video, which is much longer, so it should link to the time in the video when she talks about hot flashes (8:18) ruclips.net/video/ClrbnTmJohg/видео.html
This doctor doesn't like to maintain eye contact very much at all. Anyway, I have been on TRT for about 11 months now. My last blood test showed cholesterol is up, red blood cell count is high which can cause clotting. I was told I could just periodically donate blood to take care of the red blood cell count. Cholesterol can be taken care of with change in my diet. Those are the two things that I am experiencing so far. Everything else looks fine. Definitely easier to grow muscle now and my energy is really good. And libido is up, but doesn't matter because the wife's libido sure isn't :/
My quality of life was so poor without TRT that I got TRT before during and after treatment of G6 higher volume Pca I had SBRT two years ago and my PSA has dropped from 3.4 to 1.06 so the radiation seems to be working. I went to a clinic because my urologist refused to prescribe. I am begging him to start me back and BTW he knows I have been to the clinic. I hope I can find a urologist to prescribe because a clinic while happy to give treatment, costs much more. If I did not suffer emotionally I would not care but I get depressed and have severe anxiety-BTW my testosterone level without TRT is as low as 25!
Hi there after being on hormone treatment for 18 months and 20 radiotherapy treatments my psa Nadir was 0.01 and my testosterone was 0.58, I asked to stop the hormone treatment 6 months early and my testosterone has recovered to 17.2 after 6 months of stopping the hormones and my psa is now 0.43 which I hope is normal now my testosterone has recovered, got another test in 6 months any comments much appreciated.
One disappointment here in the UK they don't do a testosterone test before the hormone treatment starts so you know what you current level is to get a gauge of what it might return to.
I could sure use some testosterone replacement therapy. I’ve been chemically castrated since June 2008 and my level of testosterone at it’s lowest level medically possible.
This treatment is more about how the man feels. Its nothing about erection at all, because the radiation and hormone reduction Lupon etc stops men from getting an erection. Viagra etc doesn't fix that problem, the best option is an implant. In years down the track they will find all this intervention isn't giving men any longer lives for the most part, quality of life is more important.
Having this going on now …have appointment for chat with doc about shots..need testosterone back…working out almost worthless…love you vids and the knowledge you share is great and really appreciated…thanks
See my comment
Interesting that Dr. Sholtz mentions Lupron durations (4-6 mo. for intermediate risk and 12-18 mo. for high risk disease) that are a bit contradictory to a duration he mentioned in another recent video where he says he is revisiting these recommendations due to the advent/use of the PSMA test. A bit confusing for those of us trying to figure out how long to stay on ADT.
Oh my God, you guys are dead on. Thank you for backing up exactly what my body has been telling me.
The following is a summary of my cancer as I understand it and is intended to create discussion on a treatment plan that explores options and includes shared decision making.
I am a 67 year old male and I was diagnosed in March of 2022 with MRI biopsy that showed 11 of 12 cores positive mostly Gleason 6 and 7 but one Gleason 8 (4+4) and one Gleason 9 (4+5) both high percentage of core (80 percent). Had the whole body bone and pelvis scan which showed no metastasis, I kept pressing for a PSMA Pet Scan which one year ago wasn’t easy to get but my urologist thankfully agreed to ask Medicare and it was approved. The PSMA came back negative so no signs of spread on PSMA scan. My PSA never went above 10, I believe 9.5 was the highest it ever got so a slight positive I would think, but I do have high volume and high Gleason score disease. June 1st of 2022 I started Orgorvyx and had definitive Proton therapy for nine weeks (including the Seminal Vesicle and lymph nodes) then started Abiraterone mid September 2022. So I think I am one of the earliest patients to get a PSMA Pet Scan now approaching one year of ADT with Orgorvyx in June and September will be one year on Abiraterone. I know the protocols have not been worked out yet for people with High Risk Disease and a clear PSMA Pet Scan. My oncologist who I respect and am grateful to be under his care does not seem open to really entertaining the possibility of stopping the ADT early but my radiation doctor did say he thinks 1 to 2 years of ADT is sufficient, my oncologist thinks 2 years. I consider myself lucky to be getting good care and some of the latest treatments available. I promised myself I would give everything I got to cure the cancer but would not risk ruining my health with the ADT treatments. I am definitely following the advise about exercise, exercise, exercise and don’t want to damage my body more than necessary for a cure. So my PSA has been undetectable and I also have Natera
( Signatera) Genetic Residual disease testing done every 3 months which also comes back negative for any signs of disease. I feel that I am reaching the point where the cumulative effects of the ADT are becoming a big risk to my long term health and I am considering stopping the ADT at the end of August which will give me 15 months on Orgorvyx and 12 months on Abiraterone. I am presenting my case for a review as I am struggling with my decision to stop the ADT and need all the information I can get to make my choice. Thank you so much for your consideration.
Thanks for sharing; 70 underwent RT, placed under Zoladex for 8 mo, PSA & testosterone dropped from 46 & 6.7 to 0.8 & 0.3, respectively; feeling fatigued and lost muscles; oncologist gave me the option to stop ADT; my next visit I’ll ask for testosterone; quality of life matters to me.
Never make prostate cancer cells make their testosterone....cancer cells should not learn to make testosterone......
.supply little from outside in inj
I am stage 4 metastatic to bone in 4-5 locations, diagnosis in Feb of this year, no prior diagnosis or treatment and am currently about three months into ADT and finishing 6 Taxotere infusions in two weeks. Should I reasonably expect to be on hormone suppression indefinitely or might there be a scenario where after 18-24 months I might stop ADT for a while and allow my natural testosterone to come back up? I am younger, 57, and not experiencing problems with ADT side effects, I find them very manageable.
Just donated to this amazing cause. Keep the videos coming.
Thank you so much!
This is what I’m looking for; thank you!
I had IMRT for nine weeks with no hormone therapy. My current testosterone level is 400. I am 66 years old, and I am a natural bodybuilder who is considering TRT. I desire to improve my libido and get more energy and build more muscle, but I am concerned about my prostate cancer returning. Do you recommend me consulting with my urologist or primary care physician about this issue?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I was on TRT for years before my PC DX this past November. My Dr.says TRT is a no-no and I am floundering. Asked him to check and testo was 278 and falling. My PSA has dropped as my testo dropped. My DX is Gleason 6 3+3 and it would seem reasonable for me to go back in TRT. I've never felt so bad. How do I convince my Dr.? My last TRT treatment was April of 2022.
Find a new doctor that understands PCa and testosterone. Yours doesn't. A Gleason 6 is not a contraindication for TRT. Taking testosterone would have no effect on your prostate based on the saturation model.
Agree, find a new doctor
The weightlifting thing is one thing but the muscles that drive ejaculation and such, are tougher to maintain. Us married men have certain things expected of us and ADT is really making it tough.
Is it possible to get the citations for the studies that Dr. Scholz references in this video on testosterone replacement after radiation and hormone suppression therapy for prostate cancer in a moderate and high risk patient?
Thank you!
totally on poin info well presented , tks
I just had my prostrate removed and have nerve damage to my legs, how often does this occur and what can I do now
Thanks it’s very helpful.
Great talk and thanks for the education you provided on this topic. Do you have any thoughts on testosterone replacement following robotic prostatectomy? Is it safe?
Thank you. Currently SEVEN months post LUPRON treatment (after two years of zero testosterone.) My prostectomy surgery removed BOTH my seminal and prostate glands.
Right before surgery 411 was my testosterone. For seven months now my testosterone regenerated but kinda stopped at 200.
Can I take DHEA, 25 or 50 or100mg daily?,
That's the problem finding anyone who will prescribe, they have so much old information, the medical professionals are still not up with current treatments, living in the past, scared to do anything that will give quality of life.
It's the same for women too,if you have had cancer no way to get hormone therapy.
Sometimes it's best to do whatever is right for you,be your own advocate,live your best life, chances are you will live as long with or without hormones it's just how you want to live the rest of your life.
@@angelaoliver7776 Thanks Angela, 🤗😍😎
I had prostate reduction but don't remember any prostate drugs verse. But since the surgery I have poor sleep quality. I can't take testosterone for the reasons stated in the video but is there an alternative that could help improve sleep or increase sleep?
Told I'm in remission after being diagnosed with stage 4 prostate C, and a PSA over 650. After chemo, and meds @ 65 years old, PSA is barely 1, but the restoration of some testosterone would likely reverse the process. Are steroids the continuous option to staying Cancer free. Thought processes remain cloudy and explained as chemo brain. Please, what are the correct questions I should be asking? Thank you in advance.
Can a PC patient has PSA of 28.5 while Gleason score per biopsy report is 3+3. A urologist said, if PSA is in 20s, Gleason score can't be 3+3, it should be higher so biopsy report can't be right or doctors missed something. Any thoughts please?
I just went through Cyber Knife two weeks ago and I was on TRT. I would like to keep talking TRT but my Urologist through the VA won’t let me. Can you give me any advice on finding another Urologist that will work with me on TRT. I have been on TRT since 2006 when I got back from Iraq and found out that I was not making enough testosterone on my own. I will be turning 64 this coming year.
6:25 I have been able to maintain muscle mass via strength training and actually increased strength a bit.
And I have lots of energy with T levels less than 10 for over 3 months
Good stuff... Thanks !!!!
What I want to know is if I stop hormone theropy will my terrible day long sweats stop? At 75 these day long sweats have made my lifestyle really not livable. My PSA is 0.75 and my prostate and lymph nodes have reduced in size.
Hello,
We have a couple of videos that talk about that.
This one is about side effects in general, but it mentions that possibility of using an estrogen patch or a few other medications that my help with hot flashes and long sweats.
ruclips.net/video/efza9vq-cg8/видео.html
We also have this video, which is much longer, so it should link to the time in the video when she talks about hot flashes (8:18)
ruclips.net/video/ClrbnTmJohg/видео.html
If my cancer is in most of my lymph nodes do I have to stay on hormone therapy for life.
This doctor doesn't like to maintain eye contact very much at all. Anyway, I have been on TRT for about 11 months now. My last blood test showed cholesterol is up, red blood cell count is high which can cause clotting. I was told I could just periodically donate blood to take care of the red blood cell count. Cholesterol can be taken care of with change in my diet. Those are the two things that I am experiencing so far. Everything else looks fine. Definitely easier to grow muscle now and my energy is really good. And libido is up, but doesn't matter because the wife's libido sure isn't :/
I noticed the eye thing too.....strange
No eye contact? Maybe he's thinking how best to answer the question? Jesus.......
My quality of life was so poor without TRT that I got TRT before during and after treatment of G6 higher volume Pca I had SBRT two years ago and my PSA has dropped from 3.4 to 1.06 so the radiation seems to be working. I went to a clinic because my urologist refused to prescribe. I am begging him to start me back and BTW he knows I have been to the clinic. I hope I can find a urologist to prescribe because a clinic while happy to give treatment, costs much more. If I did not suffer emotionally I would not care but I get depressed and have severe anxiety-BTW my testosterone level without TRT is as low as 25!
I agree...without T quality of life sucks
Hi there after being on hormone treatment for 18 months and 20 radiotherapy treatments my psa Nadir was 0.01 and my testosterone was 0.58, I asked to stop the hormone treatment 6 months early and my testosterone has recovered to 17.2 after 6 months of stopping the hormones and my psa is now 0.43 which I hope is normal now my testosterone has recovered, got another test in 6 months any comments much appreciated.
One disappointment here in the UK they don't do a testosterone test before the hormone treatment starts so you know what you current level is to get a gauge of what it might return to.
I could sure use some testosterone replacement therapy. I’ve been chemically castrated since June 2008 and my level of testosterone at it’s lowest level medically possible.
This treatment is more about how the man feels.
Its nothing about erection at all, because the radiation and hormone reduction Lupon etc stops men from getting an erection.
Viagra etc doesn't fix that problem, the best option is an implant.
In years down the track they will find all this intervention isn't giving men any longer lives for the most part, quality of life is more important.
I was wondering if it would help with ED