Manny Hamelburg, 68, a retired businessman, had fought prostate cancer for years. First, he tried radiation, then a drug with side effects that nearly killed him, and finally Lupron, a drug that blocks production of testosterone, the hormone that can fuel prostate cancer.
The cancer disappeared. But life was miserable.
Without normal levels of testosterone, Hamelburg says, he had no energy, and "zero libido for seven years. I was like a eunuch. I was chemically castrated. Sex was just hugs."
So three years ago, with his cancer undetectable and his oncologist and urologist cautiously on board, the Holbrook, Mass., man made a decision that many doctors consider anathema: He took testosterone supplements.
"The cancer hasn't come back," Hamelburg says, "but my libido has, my sense of being alive. It's like a fog cleared. It's being aware of things, being more vibrant."
For decades, the idea of giving testosterone to a man who had had prostate cancer was forbidden -- "verboten" in the words of Hamelburg's urologist, Dr. Abraham Morgentaler of Beth Israel Deaconess Medical Center. "It would have been considered heresy, or malpractice," Morgentaler says.
That thinking is changing, due in part to Morgentaler and his new book, "Testosterone for Life."
Morgentaler argues that although depriving tumors of testosterone does make them shrink, other evidence is beginning to suggest that it may be safe to give testosterone to men who have been successfully treated for prostate cancer and who appear to be cancer free.
One revolutionary aspect of Morgentaler's theory is the observation that prostate cancer is often found in men with low testosterone levels, not high ones, underscoring the idea that taking it may not be an added risk. It's not surprising that Morgentaler -- who has received honorariums and research funding from companies selling testosterone-related products -- has generated such controversy with his ideas.
"To say that testosterone replacement therapy is safe because we have no evidence it's harmful is making an assertion on faith, not facts," said Dr. Ian Thompson, chairman of the department of urology at the University of Texas Health Science Center at San Antonio, echoing the view of other doctors who disagree with Morgentaler.
