Originally Posted by
Galoot
Yeah, I use one. But it is by prescription, since I am diagnosed with low testosterone. For the last 5 years or so I've used Androgel.
It's true that it would make prostate cancer progress a lot faster, but it doesn't require a digital rectal exam to diagnose prostate cancer. That's what is used to diagnose BPH, benign prostatic hyperplasia. I regularly take a PSA test, which is the test to see if there is early prostate cancer. It's a blood test.
That's arguable. First, neither the PSA nor the DRE (digital rectal exam)
diagnose prostate cancer (PC)- they are used in
screening, which is preparatory to diagnosis. A biopsy can diagnose PC, and not always particularly well at that, given that the procedure is done with a bunch of needle stabs at the prostate, and it's possible to miss bad cells. The final word on diagnosis is given by the surgical pathology department, after they've sliced, stained, and examined the histology of a removed prostate gland.
Second, the PSA is a crappy test when done as the only part of a PC screen. There's a huge literature on the PSA's inability to catch many PCs (false negatives that may result when a PC doesn't cause the prostate to secrete lots of the protein) and its over-reactivity to non-PCs (false positives that may happen if you've just had sex or you have a viral infection or prostatitis or whatever). While the DRE is likewise not sufficient to screen for PC, it can, when done by a skilled practitioner, detect nodules and other irregularities in the shape (e.g., asymmetry) or consistency of the prostate- these can suggest the presence of a PC. A positive DRE and a negative PSA are cause for some concern, just as an elevat
ing (or highly elevat
ed) PSA and a negative DRE are. The urology literature is pretty convincing that if you're going to screen for PC, you should do both the DRE and the PSA. But many docs don't do the DRE because they really don't feel confident in their skill at doing it correctly. And men have been known to suddenly remember that they have to get back to work when the glove and lube come out of the drawer.
All this said, two out of the three guidelines out there do not mandate routine PC screening, but rather a discussion with patients about the pros and cons of doing it. The jury is really out on this stuff- it's a very controversial procedure, because of the false negatives and positives I described above. The decision to screen or not is ideally a shared one- between a man and his doc. Problem is, most men, and many, many docs don't really understand the issues here.
In your case, or for any guy who's on test supplements, frequent monitoring of prostate status is essential. To the OP- my bet is that if you go to your doc and tell him/her that you're on a test supplement (unless you have a good clinical reason to be), s/he's gonna tell you to stop. And with good reason.
Sorry for the rant.