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Diagnose with prostate cancer. Suggest ways to bring down testosterone?

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Urologist
Practicing since : 1991
Answered : 1415 Questions
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Hi there I have diagnose with stage 4/5 prostate cancer, is there another way to bring down my testosterone?
Also should I consider surgical castration. I am a black male 69 years old, it seem like a lot work to keep up
with that treatment.
Posted Tue, 15 Oct 2013 in Cancer
 
 
Answered by Dr. G.Srinivasan 1 hour later
Brief Answer:
Surgical castration is a good option

Detailed Answer:
Welcome to the forum.
Treatment for prostate cancer depends on the stage.

If the cancer is confined to the prostate as defined by the tests, then prostate removal is necessary - called radical prostatectomy.

But if the cancer has spread outside the prostate, the treatment is to get rid of the testosterone to CONTROL the tumor cells , as these cells are dependent on testosterone for their growth.

Testosterone can be got rid of by some methods--

1. Medical castration- where injections are given ranging from monthly to 6 monthly to keep the testosterone levels low. But these injections need to be repeated.
2. Surgical castration - where both the testicles are removed. It is a one time approach.
There are pros and cons for both and you may discuss with your doctor which is best for you.
Best regards
Above answer was peer-reviewed by
 
Follow-up: Diagnose with prostate cancer. Suggest ways to bring down testosterone? 22 hours later
my urologist has started me on a oral hormone bicalutamide , but want add
Lupron with it, what the risk that it might have an reversed affect?
 
 
Answered by Dr. G.Srinivasan 1 hour later
Brief Answer:
correct line of treatment

Detailed Answer:
Welcome back.
You are on the right line of treatment , that is complete androgen blockade.
Adverse events may happen, we want effect first to control the disease.
regards
Above answer was peer-reviewed by
 
Follow-up: Diagnose with prostate cancer. Suggest ways to bring down testosterone? 19 minutes later
in regard to my second question, if taken Lupron along with Bicalutamide has
and reverse affect, am I stuck with that or is there help if this would happen?
 
 
Answered by Dr. G.Srinivasan 7 hours later
Brief Answer:
No reverse effect

Detailed Answer:
Welcome back,
I understand your question.
Bicalutamide first blocks the androgen receptor and hence prevents the possible initial androgen surge or rise that can happen with Lupron.
So, the sequence is usually followed and that is what your urologist has done.
So the reverse effect does not happen.
The advantage with such treatment is that if androgens do not help you or instead help the cancer to grow ( which is possibility at some point), the medications can be withdrawn. The same is not possible with surgical castration, which is a one time event.
Hope i have made things clear.
Wish you good health,
Best regards

Above answer was peer-reviewed by
 
Follow-up: Diagnose with prostate cancer. Suggest ways to bring down testosterone? 12 hours later
Should my Urologist start treating me for my prostate problem before I see a
oncologist who special in prostate cancer?
 
 
Answered by Dr. G.Srinivasan 2 hours later
Brief Answer:
makes no difference

Detailed Answer:
Hi,
treatment offered will be the same by both doctors.
So, it depends on other factors like accessibility, appointment issues and so on.
best regards
Above answer was peer-reviewed by
 
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