EP292: Timing testosterone suppression for prostate cancer treatment | PUTTING DR G ON THE SPOT - video Dailymotion

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Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, answers a question on how the treatment for prostate cancer can reduce the risk of infertility.  WATCH MORE: https://thestartv.com/c/news SUBSCRIBE: https://cutt.ly/TheStar LIKE: https://fb.com/TheStarOnline

Transcript

00:00Hello there, welcome to another episode of Putting Dr. G on the Spot.

00:03In the month of September, we're focusing on prostate cancer.

00:08And while we're focusing on prostate cancer, we're specifically zooming into sexual dysfunction.

00:13On this occasion, we're talking about libido and how is prostate cancer affecting libido.

00:25We all know that libido is affected by testosterone.

00:30And the testosterone itself actually has various forms.

00:32It has a total testosterone, the free testosterone, and the active form of testosterone, which is dihydrotestosterone.

00:41In fact, in the 1940s, it was discovered by Huggins, who is a very well-known scientist,

00:48who worked out that there's a correlation between enlarged prostate and also testosterone.

00:55In fact, there is a correlation between removal of the testosterone and also control of metastatic prostate cancer.

01:03So, that correlation is immediately put that high testosterone is related to prostate cancer.

01:10However, that's not always true because we know that the vast majority of men

01:15who encounter problem with prostate cancer don't necessarily have high testosterone

01:21and also low testosterone is noted to be associated with high-risk prostate cancer.

01:29But what we know is that when somebody is affected by the low testosterone due to the treatment of prostate cancer,

01:38then the person will encounter problem of low libido.

01:43For example, if someone presented with metastatic prostate cancer,

01:48so that means that the prostate cancer is already stage 4,

01:51and this person will require suppression of testosterone.

01:56It's called androgen suppression therapy.

01:59When that occurs, sure enough, the testosterone level will be reduced and libido will be reduced.

02:05And for these patients, their sexual desire is significantly reduced.

02:11On the other hand, before men undergo radiotherapy for prostate cancer,

02:16they also need to have the similar testosterone suppression.

02:21And such suppression is associated with significant depression of the libido,

02:28and this may go on between 2 to 3 years after the treatment.

02:33However, in the second group of patients,

02:35the suppressions of this treatment actually is only for a short period of time,

02:42and then the libido will recover.

02:44So, will prostate cancer patients be amenable to have testosterone replacement therapy?

02:52The answer is we actually don't know because we know too much testosterone may activate the prostate cancer cells.

03:01Therefore, it is absolutely contraindicated for prostate cancer patients

03:06to receive testosterone replacement therapy even though they actually have significant low libido.

03:14So, from one sexual dysfunction, such as low libido, associated with prostate cancer,

03:21we are going to talk about another sexual dysfunction,

03:25which is the problems of erectile dysfunction associated with prostate cancer.

03:31Do you think prostate cancer can cause sexual dysfunction, such as erectile dysfunction?

03:36If you worry about so, then you need to stay tuned for next week's Putting Dr. G on the Spot.

03:44I'll see you next week.

EP292: Timing testosterone suppression for prostate cancer treatment | PUTTING DR G ON THE SPOT

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