sexual desire increase

User

Posted 24 Jul 2023 at 11:47

About 5 years ago I had a radical Prostatectomy, just over a year ago it returned to my bones and destroyed by radio therapy. This was followed up by hormone treatment a chemical castration to remove testosterone. Psa <0.1. Usual side effects followed. My sexual desire dropped totally until now, when it is starting to return. My worry now is the testosterone returning somehow?

User

Posted 28 Jul 2023 at 19:35

When HT stops working and you become castrate resistant, it's not due to Testosterone returning.

It is possible a HT injection didn't work - ask for a Testosterone test if you're worried about that. I got a few unexpected erections a week before starting RT (exactly when you don't want HT to fail), so went and got a Testosterone test from my GP. it was 0.2nmol/L (which is very low even when on HT), so it wasn't that my Testosterone was coming back.

About 20% of guys on HT can still get erections, and you may be one of the lucky ones. This rate increases with the use of Viagra or Cialis, but no one has ever researched by how much. This is harmless (actually, quite the opposite, it's beneficial).

User

Posted 24 Jul 2023 at 17:27

Oh No! I hope not🤞 It’s not Permanent only as lng as you are taking HT? I think the reason they keep you on it for some time after RT is finished is that the combination of RT and then HT can kill of any micro cells wh He might be in the area surrounding the prostate.

as I understand it as soon as you stop taking HT your testosterone should start to return. I would say you are doing well if your desires are returning after 6/7months since stopping.

it can be an anxious time though when checking your PSA as the block is no longer there.

But…there’s no point in worrying about it, enjoy your testosterone and onwards and upwards!

Derek

User

Posted 24 Jul 2023 at 21:08

Hi rookuk,

Decho is right that castration is only whilst on HT and testosterone returns after six months to a year if you stop HT.

As the cancer has spread to your bones, it is usual to be put on HT for the rest of your life. So the question is why was HT stopped? Some oncologists do stop HT for a few months, this is referred to as a HT holiday, but it is quite rare to find an oncologist who does this.

It is worth asking your oncologist why you are no longer on HT, and if the plan is to resume it, or try some other way to slow down the progress of cancer?

Dave

User

Posted 24 Jul 2023 at 23:53

The conventional thinking is that if they discover even one met beyond the prostate, you probably have more, which are at the moment undetectable but will surface later. Treating these with SABR was considered to be like playing Whack-a-mole.

However there is now a school of thought, that a small number (less than 5) may be genuinely the full extent of the cancer so if these are zapped you can be cured.

Google "Dr Kwon Oligometastatic prostate cancer" to find out more from a US doctor who espouses this theory.

This is not mainstream thinking yet, but it needs investigating. You would be an ideal candidate to test this theory. There is little downside to your oncologist stopping HT as long as you are closely monitored, if the cancer was found to have returned restarting HT would leave you no worse off* than if you had remained on HT, but if it never returned you would be much better off than continuing a life of treatment that may not be needed.

*No worse off. Well the cancer may have spread a little further, but you will gain an extra few months before the cancer becomes hormone resistant. So I will stand by the phrase 'no worse off'. Please bear in mind I have no medical training.

Dave

User

Posted 25 Jul 2023 at 08:05

This sounds like treatment for a very small number of mets discovered after completion of a treatment given with curative intent. It is standard NHS England treatment, but still not widely offered, especially if the hospital itself doesn't do it (one of my pet peeves).

Stereotactic ablative radiotherapy (SABR) for patients with metachronous extracranial oligometastatic cancer

Metachronous means discovered after a treatment given with curative intent
Extracranial means not in the skull
Ogliometastatic means no more than 5 small mets, but actually this treatment is limited to 3 small mets, and many oncos limit it to fewer even than that.

The cure rate isn't high, but it's worth it even when it doesn't cure, as it puts off the need for further treatment for some time, and is considered worthwhile even just on that basis.

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User

Posted 24 Jul 2023 at 13:34

Hi Rookuk,

have you finished HT? If so how long ago? Your testosterone should start to return if you’ve completed HT but it seems to vary from person to person how long this takes.

User

Posted 24 Jul 2023 at 15:35

I think it was about 6 or 7 months ago i stopped having HT. I thought the castration would have stopped any testosterone from returning.

User

Posted 24 Jul 2023 at 17:27

as I understand it as soon as you stop taking HT your testosterone should start to return. I would say you are doing well if your desires are returning after 6/7months since stopping.

it can be an anxious time though when checking your PSA as the block is no longer there.

But…there’s no point in worrying about it, enjoy your testosterone and onwards and upwards!

Derek

User

Posted 24 Jul 2023 at 21:08

Hi rookuk,

Decho is right that castration is only whilst on HT and testosterone returns after six months to a year if you stop HT.

It is worth asking your oncologist why you are no longer on HT, and if the plan is to resume it, or try some other way to slow down the progress of cancer?

Dave

User

Posted 24 Jul 2023 at 22:06

I think there is some info missing here. If the cancer had returned and spread to bones, it wouldn't have been eradicated by RT and then short term HT. Either it was a recurrence in the prostate bed which was zapped with salvage RT and short term HT OR the poster has had SABR which the onco believes was successful in which case you would have expected the HT to go on a bit longer but maybe QOL was a factor?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 24 Jul 2023 at 22:35

Yes you're right, it was SABR, but very tiny in my shoulder and hip and they said it was all clear. But I think I'll take advice from the other posters to contact the oncologist for further information. Thank you all for advice.

User

Posted 24 Jul 2023 at 23:53

However there is now a school of thought, that a small number (less than 5) may be genuinely the full extent of the cancer so if these are zapped you can be cured.

Google "Dr Kwon Oligometastatic prostate cancer" to find out more from a US doctor who espouses this theory.

Dave

User

Posted 25 Jul 2023 at 08:05

Stereotactic ablative radiotherapy (SABR) for patients with metachronous extracranial oligometastatic cancer

The cure rate isn't high, but it's worth it even when it doesn't cure, as it puts off the need for further treatment for some time, and is considered worthwhile even just on that basis.

User

Posted 28 Jul 2023 at 17:43

In January 2922 I was diagnosed with locally advanced PC which was treated by RT last August. I have also been on HT for 18 months and have another 6 months to go. A few weeks ago I was concerned that my penis and testicles seemed to have shrunk considerably so I bought a vacuum pump and also tried some masturbation. Lo and behold it wasn't long before things were almost back to their original size.

My worry is that i am now starting to feel a stirring of sexual desire. Could it be that the HT is no longer working properly?

User

Posted 28 Jul 2023 at 19:35

When HT stops working and you become castrate resistant, it's not due to Testosterone returning.

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