Author Topic: Orchiectomy & PSA Levels  (Read 400 times)

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Offline BeckyCNJ

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Orchiectomy & PSA Levels
« on: November 04, 2020, 10:58:57 am »
For over a decade I have had very high PSA numbers and a quite large prostate. I've had four biopsies and just last month an MRI of my prostate. Fortunately, all were negative with no indication of prostate cancer.

I asked my urologist if estradiol and/or spiro would lower the PSA number or decrease the size of the prostate and he said it wouldn't.

Doing research I was only able to find indications that orchiectomies are used in advanced cases of prostate cancer. It does seem some prostate cancer cells are fueled by the androgen produced by the testes. I imagine most cis-men would not want to get an orchiectomy as a preventative measure. As a trans-woman I would not mind losing this part of my male anatomy.

I would like to be proactive in lowering my risk of prostate cancer and, hopefully, avoid the need for a biopsy or MRI every year. Has anyone found that an orchiectomy lowered your PSA levels or decreased the size of your prostate?

Thanks!

Becky


Offline Gertrude

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Re: Orchiectomy & PSA Levels
« Reply #1 on: November 04, 2020, 01:30:07 pm »
I thought they gave Spiro to people with prostate cancer to lower T?

Offline AllieSF

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Re: Orchiectomy & PSA Levels
« Reply #2 on: November 04, 2020, 03:35:30 pm »
Becky,

I have heard that the testes, being a source of testosterone, is linked to prostate cancer in some way, and that prostate removal sometimes is recommended to reduce its effect.  I had prostate cancer and had it removed in 2005, and have been clean ever since.  I think that you need further discussions with your urologist or get a second opinion to help you clarify your doubts and to make a decision. 

Good luck,

Allie
HRT - February 2017
Full Time - July 2018
Orchi - January 2018
BA - September 25, 2019
FFS - January 10, 2020
GRS - TBDDD (To Be Determined, Decision and Date)

Offline JudiBlueEyes

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Re: Orchiectomy & PSA Levels
« Reply #3 on: November 04, 2020, 06:47:54 pm »
I had it too and had surgery to remove the prostate.  My PSA numbers were always low and the gland was not enlarged.  I had other indications.  I agree that speaking with your urologist is a good idea.  The idea of recurring biopsies would not be desirable or fun.  I would think that estrogen would reduce the size of the prostate.
Wind blew in, cloud was dispersed
Rainbows appearing, the pressures were burst
Breezes a-singing, now feeling good
The moment had passed like I knew that it should

Offline Rakel

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Re: Orchiectomy & PSA Levels
« Reply #4 on: November 04, 2020, 08:00:51 pm »
Estradiol does reduce the size of an enlarged prostate. The difficult part is finding a Urologist or Endocrinologist who is willing to prescribe this for you unless you tell them right away that you are in counselling for gender issues.

Spironolactone does not directly lower your Testosterone blood level. It blocks the receptors so that any Testosterone is much less effective.

In my situation, I had an enlarged prostate and under went a TURP. The Urologist did not take out enough of my prostate and I still had some discomfort down there in that area. As things got worse, I made additional appointments with other doctors and the rest is history. I did not transition just because of my prostate issues. I had other issues as well and my prostate condition was just one of several issues that lead me to transition.

One bit of advice, If you have prostate surgery like I did, then GCS, some surgeons will not operate at all and others will suggest limited depth or even zero depth GCS. Consult with all your prospective surgeons before doing any surgery. One procedure may exclude you from doing anything further.





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Offline AllieSF

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Re: Orchiectomy & PSA Levels
« Reply #5 on: November 04, 2020, 08:26:14 pm »
Rakel,

That just happened to me.  Dr. Satterwhite in San Francisco very recently told me the same thing, too much potential scar tissue issues.  However, he said other doctors, may be willing to deal with it.  Maybe the peritoneal pull through avoids those issues??

Allie
HRT - February 2017
Full Time - July 2018
Orchi - January 2018
BA - September 25, 2019
FFS - January 10, 2020
GRS - TBDDD (To Be Determined, Decision and Date)

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