prostate cancer

[C/D gweny (imported)]

my question ,,,is castration recommended by prostate cancer and will the urolog agree , as i thought it will cut out the testosterone production as it actually feeds the cancer ?

reg. GWENY

[gellyfregy (imported)]

That has been true in the past. I keep hearing conflicting things about whether it is still a preferred treatment ... that is, whether survival rates are longer for other treatments than for guys who undergo hormone(-reduction) therapy.

[Woggler58 (imported)]

I looked up Windhoek, Namibia before replying and find an interesting history and that many languages are spoken there. And I also see in your profile that you are 57 -- old enough for prostate cancer to now be possible -- and that you are interested in becoming castrated for non-medical personal reasons. You appear to wonder if castration is medically accepted to prevent possible prostate cancer and if so, perhaps you could have the surgery and enjoy its personal benefit to your lifestyle desires. Yes?

Elimination of testosterone is medically accepted to greatly retard growth of active prostate cancer that has not been cured by any of several primary treatments already administered. It can also reduce the size of a cancerous large-size prostate gland in advance of administering radiation to that gland making a smaller, better target.

Surgical castration and (much more dear) chemical castration are the two most-accepted methods to eliminate testosterone. Administering (least dear) bio-identical estrogen "parenterally" (meaning NOT by mouth and stomach) to overwhelm and suppress natural testosterone production is beginning to be used, due to not having the excessive side effects that orally taken non-bio-identical estrogen caused when used instead of castration.

If you have not yet been diagnosed as having an active cancer, you can expect trouble finding a doctor to castrate you. Same if you have been diagnosed with curable prostate cancer but have not tried and failed an accepted curative treatment. Surgical castration is not reversible and does cause health-diminishing side effects so it is not generally acceptable to medical doctors for men without a condition as serious as active prostate cancer.

"Hormone treatment" for prostate cancer patients means to deprive the patient's body of as much testosterone as possible -- as much as surgical castration reliably does. Partial reduction does not work for either preventing cancer or stalling growth of a cancer already present. It is acceptable to all doctors (but not preferred by all doctors) to use temporary chemical castration just before, during, and/or just after cure-intended prostatectomy, prostate radiation, or other "primary" treatment -- as "adjuvant" hormone treatment.)

Your special personal situation seems unlikely to get you a "ticket to ride" into being castrated by a mainstream medical establishment. You have to have a confirmed risk of otherwise untreatable metastatic prostate cancer (or already be metastatic) to find a doctor happy to castrate you, because only then do they regard the harm to you as less than not doing the castration.

[C/D gweny (imported)]

many thanks , well you are right ,quite nice here in southern africa.

what actually happened has nothing to do with my previous postings and has nothing to do with my new situation . after several bladder infections , i with send to do the blood test and it showed around the 15 mark .

biopsy was done and i was tested positive on prostate cancer . how ever i am going for the brachytherapy to capetown beginning next year and have my first appointment there in the beginning of january .my question still remains if a castration in that case is helping and advisable .

best reg. GWENY

[Ringdijk (imported)]

Hi C D Gweny,

Let's tell you my story, i was diagnosed with prostate cancer six years ago.

PSA around 30, gleason 7.

Treatment HIFU and later EBRT.

To get optimal result my urologist gave me the choice between Zoladex, Cosodex and

Orchiectomy.I did chose for the Orchiectomy option, happy with the eunuch status, however keep in mind it also has negatif effects.

[JesusA (imported)]

I sent the first part of this thread to a prostate cancer expert. Richard is a retired professor of neuroanatomy in a medical school who has been on chemical castration (high dose estrogen) for many years to cope with his own PCa. Since he retired, he is now heading up a prostate cancer education center in Canada. Richard has been a major factor in research into the voluntary eunuch community and is partly responsible for Male-to-Eunuch becoming more accepted in the medical field, especially with his contributions toward the WPATH Standards of Care and the new DSM-5.

Here is Richard's response:

Woggler58 knows his stuff. He is either an MD or a prostate cancer (PCa) patient, or both. I'm rather curious to know his background.

All I would add to the thread is:

1. For economic reasons surgical castrations are still, most assuredly, done to treat the poor PCa patients in poorer countries. That includes South Africa.

2. Gweny has good grounds to ask his MD for a short-term course of an LHRH drug, such as Firmagon.

3. Gweny might want to get a copy of the ADT book to know what he might have to deal with as a PCa patient on androgen deprivation therapy. The book is available in hardcopy or ebook from Amazon.com.

Richard W.

The book is designed for both the PCa patient and his partner, though it also is excellent for voluntary eunuchs as well. The full title is Androgen Deprivation Therapy: An Essential Guide for Prostate Cancer Patients and Their Loved Ones, by Richard J. Wassersug, Lauren M. Walker, and John W. Robinson (New York: Demos Health, 2014).

There are excellent chapters on the physical and psychological side effects of loss of testosterone. There is good information on exercise and diet. There is a section on retaining sexuality, which is important for PCa patients who do not want to become asexual after chemical or surgical castration.

On a separate note:

There was an interesting article published in the journal European Urology in 2013 that surveyed ALL prostate cancer patients added to the Danish Cancer Registry for the years 2002 through 2010. There were 31,571 PCa patients, of whom 9,204 were put on long-term chemical castration and 2,060 were surgically castrated. Those who were chemically castrated had significantly higher rates of heart attack and strokes than those surgically castrated, whose risk was unchanged from those not castrated.

Jespersen, CG, Norgaard, M, & Borre, M. (2013) Androgen-deprivation Therapy in Treatment of Prostate Cancer and Risk of Myocardial Infarction and Stroke: A Nationwide Danish Population-based Cohort Study. European Urology. http://dx.doi.org/ 10.1016/j.eururo.2013.02.002

[uncowled (imported)]

All good answers.

I was diagnosed with PC in 2011 with a Gleason of 3+4, it was in both lobes and all but one core proved positive. It was however, contained within the capsule. The Urologist who also practiced surgery and cryotherapy recommended both. I went for a second opinion to an oncologist who recommended radiation (he was a radiologist). This in fact seems common most prostate specialists seem to recommend their own strengths as the best curative option!

In the end I chose radiation, 42 sessions of Tomotherapy, basically because from what I read there was little difference in the expectations of survival and also there seemed to be less side effects, continually having to wear diapers until one hopefully regained control did not fill me with enthusiasm nor was it really viable if I was to try and retain my job with its associated medical benefits!

I was expecting to be castrated I assumed chemically as that appeared the norm but was not. When I queried about that I was told my prostate was only 35cc and as such was an acceptable size and consequently did not need shrinking.

I duly went through the treatment and now am at a PSA of .29, six months ago it had gradually fallen down to .28. The specialist was not concerned at the small rise and said it was the overall trend they looked at. If it did continue to rise which he was not expecting then they would suggest hormone therapy (a discreet way of phrasing chemical castration) the cost of which over a typical period staggered me and would severely curtail my resources. When I remarked on that he did say that similar results could be obtain with a bi-lateral orchiectomy, once again a discrete way of saying having your nuts cut off, which was a 'simple' day care procedure. He did say the downside to that was the psychological impact of permanent castration (he did not realize I had been fascinated by castration ever since my early teens lol) and also it prevented what he called the use of intermittent hormone therapy.

Subsequent research showed that although obviously permanent and the end results and side effects were similar orchiectomy seemed to have a less detrimental effect on other parts of the body such as the liver etc., and sometimes even had a beneficial effect on blood pressure although this could be moot!

Unlike most surgical prostate patients I was still capable of erecting after my procedure had finished although it seemed harder work and my emission seemed the same as before.however, within six to nine months I was impotent and my emission ad greatly reduced to sometimes being non-existent.

For me, I trust as I wish to other sufferers no further rise in PSA. If it does I will elect castration by surgery both for health organ safety and financial reasons. I had never considered that one day my interest might be assuaged for genuine medical benefits!

[C/D gweny (imported)]

many thanks to all for the positive input , lets see were we go from here . next week i am in for bone scan and in January i have an appointment with the specialist in Capetown. my urologist here still refuses a castration in this stage she believes it is to early , well lets see what happens in Capetown in the beginning of January , i keep you posted .

best reg. GWENY

[micdavi24 (imported)]

I hope the south easter isn't blowing you guys inside out LOL. For the record, I used to live in Tableview. Good luck with the urologist, who are you seeing there.

[C/D gweny (imported)]

I hope the south easter isn't blowing you guys inside out LOL. For the record, I used to live in Tableview. Good luck with the urologist, who are you seeing there.

thanks , do you perhaps know him at panorama ?? reg. GWENY