Hello Law, what an incredibly complex gland the prostate is. I confess I haven’t heard of sclerosing adenosis until I read your profile. It appears it is a benign condition.
I found an article which included a short section on this. See below.
“Sclerosing adenosis of prostate is very similar to that of breast. It is a benign lesion with the hyperplasia of both small acini and fibrous stroma. The lesion presents as nodular with well-defined boundary, but without capsule (27). Its histological feature is that the variable sized or shaped glands disorderly embed into prominent sclerotic stroma (Figure 2G). There are both clear secretory cells and amphophilic basal cells in the hyperplastic glands. Besides, some glands are surrounded by a layer of thick and eosinophilic basement membrane-like matter. The cells may have prominent nucleoli and intraluminal acid mucin. Sclerosing adenosis should be distinguished from small acinar adenocarcinoma. In IHC staining, the basal cells are not only positive for HMWCK (e.g., 34βE12, Figure 2H), CK5/6 and p63, but also positive for smooth muscle actin (SMA) and S-100 protein, which suggests those cells have myoepithelial differentiation (28,29).”
The full article can be found here
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779757/pdf/cjcr-28-01-072.pdf
Having also read about testosterone reference levels it states between 10 and 27 is normal and that this should be measured between 8 and 10 a.m. as this is when T levels are highest.
I have no experience of TRT, because I am on HT I will be at castrate level of T.
Hopefully others will come along and answer too.
All the best.
|
User
I am fatigued and sleep is disturbed plus hot flushes too. Having said that I walk, play sports and am very active. I just get very tired.
It’s a blast!
Hope you get things sorted out.
|
User
My case was very complex so it was all a bit of a mess. Long history of mental issues although holding a very good job. Pituitary issues which were affecting T and thyroid levels , shift work , young child etc etc. I’m not surprised no one could make their mind up. My T level was lower than normal but my stimulating hormones were low too. Massive sleep problems and borderline chronic fatigue syndrome. I eventually lost my job and was diagnosed Pca 6 months later. I’m not sure what to say , other than if you try it I would insist given your history on at least 3 monthly psa tests or have them done privately
User
Before my diagnosis I was on Testosterone ( gel ) for about 4 years, my level before the gel was 8 ( not sure of units).
I had fatigue, ED, and poor concentration etc. the Testosterone made a huge difference to my general well being. I had regular PSA tests and 12 months before diagnosis they started to rise, slowly at first but then a couple of rapid rises ( +1 TO 8.8 and then to 10.8) so then the usual tests and final diagnosis. I had brachytherapy about 2 months back and all is going fine, hopefully I will eventually be "cured".
Did the testosterone "feed" the PCa? My urologist thinks that it didn't but some information on the web says otherwise. My testosterone level using the gel was up to about 15, and as the urologist said, " that is only about normal" so maybe I was going to develop PCa anyway, who knows?
Strangely I now feel fine, I am no longer on testosterone gel of course, I still have ED and some tiredness, my concentration and memory are OK but not perfect, but then I am 75 years old so maybe it's normal!
In hindsight I would not have started the hormone replacement, although the benefits were great there was the possibility of feeding a PCa and that risk was never mentioned ( if it existed).
I hope my experience might help you in making your choices, good luck.
John
Edited by member 19 Dec 2018 at 16:41
| Reason: clarification
Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2 Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23 <0.01 |
User
Latest thinking is that PC needs testosterone BUT increasing levels does not stimulate PC growth further.
User
It was not instant by any means, it took about 4 months to have an effect and get the dose sorted out, they ( the docs) tend to start at a low dose and build up.
The results, as I indicated, were very satisfactory and noticeable.
John
Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2 Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23 <0.01 |
Show Most Thanked Posts
User
Hello Law, what an incredibly complex gland the prostate is. I confess I haven’t heard of sclerosing adenosis until I read your profile. It appears it is a benign condition.
I found an article which included a short section on this. See below.
“Sclerosing adenosis of prostate is very similar to that of breast. It is a benign lesion with the hyperplasia of both small acini and fibrous stroma. The lesion presents as nodular with well-defined boundary, but without capsule (27). Its histological feature is that the variable sized or shaped glands disorderly embed into prominent sclerotic stroma (Figure 2G). There are both clear secretory cells and amphophilic basal cells in the hyperplastic glands. Besides, some glands are surrounded by a layer of thick and eosinophilic basement membrane-like matter. The cells may have prominent nucleoli and intraluminal acid mucin. Sclerosing adenosis should be distinguished from small acinar adenocarcinoma. In IHC staining, the basal cells are not only positive for HMWCK (e.g., 34βE12, Figure 2H), CK5/6 and p63, but also positive for smooth muscle actin (SMA) and S-100 protein, which suggests those cells have myoepithelial differentiation (28,29).”
The full article can be found here
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779757/pdf/cjcr-28-01-072.pdf
Having also read about testosterone reference levels it states between 10 and 27 is normal and that this should be measured between 8 and 10 a.m. as this is when T levels are highest.
I have no experience of TRT, because I am on HT I will be at castrate level of T.
Hopefully others will come along and answer too.
All the best.
|
User
Thanks for your reply, out of interest how do you feel on HT? The main problem I have is extreme fatigue to the point I can't even follow a conversation, completely out of it. Also disrupted sleep and what seems like very light sleep. I wonder if testosterone is a red herring given it is within the normal range and people such as yourself function ok (assuming here) with near to zero?
User
I am fatigued and sleep is disturbed plus hot flushes too. Having said that I walk, play sports and am very active. I just get very tired.
It’s a blast!
Hope you get things sorted out.
|
User
I saw a consultant privately at age 45 due to unexplained ED and significant loss of ejaculate. He did test psa and it was 4 , so was high. They ignored the result. They also found I had pituitary gland problems. Their decision was to put me on TRT. At first Testogel which is a flipping mess , and then injections which helped a bit. They ignored a psa of 6 and then forgot to test again. When prompted by me for a test it came back at 15 and then I had surgery and am now incurable. I believe I already had prostate cancer and it was missed , and they actually fed the cancer tbh. I think ED and reduced ejaculate are way down on the symptoms list , because traditionally it is an older mans disease and these things happen naturally, but I think big alarm bells should be ringing in younger men with sudden onset
User
Thanks for you reply Chris, I remember reading your profile when this all kicked off for me a couple of years ago. Experiences like yours push me towards not trying it, thanks for sharing this. That said I haven't had sudden onset ED or reduced ejaculate, and my PSA has reduced from a high of 12 to the lowest ever at 1.6 but the stakes are high, I'm thinking more and more it's not worth it! Can you remember your testosterone level? Did you have the fatigue and sleep problems I described above?
User
My case was very complex so it was all a bit of a mess. Long history of mental issues although holding a very good job. Pituitary issues which were affecting T and thyroid levels , shift work , young child etc etc. I’m not surprised no one could make their mind up. My T level was lower than normal but my stimulating hormones were low too. Massive sleep problems and borderline chronic fatigue syndrome. I eventually lost my job and was diagnosed Pca 6 months later. I’m not sure what to say , other than if you try it I would insist given your history on at least 3 monthly psa tests or have them done privately
User
Ok thank you, Chronic Fatigue Syndrome is what they have told me also, this is really a final shot before accepting that diagnosis as everything else was normal, thyroid, pituitary etc. CFS appears to be an open ended illness, don't know what causes it don't really know how to treat it etc. I'll give it some thought, I have my PSA every 4 months as it is next in February so I will definitely insist on that if I do try it, the uro suggested 4 weeks after I start (if I start) so at least I feel they are considering PSA and my history.
More importantly best of luck with your treatment, I hope you are holding up ok.
User
Before my diagnosis I was on Testosterone ( gel ) for about 4 years, my level before the gel was 8 ( not sure of units).
I had fatigue, ED, and poor concentration etc. the Testosterone made a huge difference to my general well being. I had regular PSA tests and 12 months before diagnosis they started to rise, slowly at first but then a couple of rapid rises ( +1 TO 8.8 and then to 10.8) so then the usual tests and final diagnosis. I had brachytherapy about 2 months back and all is going fine, hopefully I will eventually be "cured".
Did the testosterone "feed" the PCa? My urologist thinks that it didn't but some information on the web says otherwise. My testosterone level using the gel was up to about 15, and as the urologist said, " that is only about normal" so maybe I was going to develop PCa anyway, who knows?
Strangely I now feel fine, I am no longer on testosterone gel of course, I still have ED and some tiredness, my concentration and memory are OK but not perfect, but then I am 75 years old so maybe it's normal!
In hindsight I would not have started the hormone replacement, although the benefits were great there was the possibility of feeding a PCa and that risk was never mentioned ( if it existed).
I hope my experience might help you in making your choices, good luck.
John
Edited by member 19 Dec 2018 at 16:41
| Reason: clarification
Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2 Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23 <0.01 |
User
Thanks John, I'm thinking I'm going to leave it...
12.2 doesn't seem low enough for a start, it's probably the poor sleep etc causing it to be lower (was 14.4 a couple of years ago) rather than vice versa, also this all started in the weeks prior to having my first PSA test in a year after the previous one which prompted a biopsy etc was 12... I had no idea what to expect after such a long time...
How long did the testogel take to make a difference to you out of interest?
Good to hear the treatment is going ok!
User
Latest thinking is that PC needs testosterone BUT increasing levels does not stimulate PC growth further.
User
trt is mostly suitable for low risk pc,but what about us high risk locally advanced pc,i am suffering without testesterone,my testesterone is below reference limit,4.55nmol/l.
User
It was not instant by any means, it took about 4 months to have an effect and get the dose sorted out, they ( the docs) tend to start at a low dose and build up.
The results, as I indicated, were very satisfactory and noticeable.
John
Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2 Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23 <0.01 |
User
Hi, everyone,
I may well be going down the HRT route soon as I have suffered the side effects of Zoladex etc. including fatigue, forgetfulness, erectile dysfunction, body image issues and so on. my urologist has referred me to an endocrinologist so I'll see what happens. The urologist felt that the risk of prostate cancer recurrence was low but i'll see what the endocrinologist says. In the meantime I've now picked up the new diagnosis of 'Hypogonadism' - sounds like a playground insult so i'll settle for the American term 'Low T'. I'll post here with any news but will expect a thorough explanation from the next consultation (if it gets that far).
User
A couple of years after my LRP, my testosterone level was found to be almost zero. I'm not sure how long it had been like this - it was the first time it had been checked. After an eternal fight with Endocrinology, searching the Internet and so on, I was "allowed" TRT on the basis that, as I no longer had a prostate, prostate cancer was unlikely... After some excitement with Testogel where my T level went up to 14, eventually it was managed back to 4. The result was not a lot different from before the TRT - fatigue, loss of concentration and long lasting, lousy coughs and colds. Then my haemocrit level started rising and Endocrinology, with a lot of "I told you so" banned further TRT. With one hand it is given, with the other it is taken away.
Sorry, trying not to depress readers, but am feeling like c**p at the moment especially as a hacking cough, when it occurs, defeats my AUS technology (that, otherwise, is performing very well).
Tony
TURP then LRP in 2009/2010. Lots of leakage but PSA < 0.1 AMS-800 Artificial Sphincter activated 2015. |
User
Hi, Tony. It's ok to share the story. The more I know the better.
User
Endocrinology appointment in january 2020! Ha, ha. That's really funny.