Odds of prostate cancer in post-HRT trans women

[Dana Michelle]

Does anyone have any idea what the odds are of transgender women getting prostate cancer? Prostate cancer runs in my family. I asked my endocrinologist and she said there has not been enough research to determine the odds. I wonder if there is at least anecdotal reports of what the odds are. Does anyone know? I found an article that said there have only been four reported cases of prostate cancer in transgender women, all of which started HRT after age 45 (I started at 36) https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00439-8/fulltext. However, there could be many more unreported cases.

 

I do plan to have prostate cancer screening once I am 50 years old, but I am still wondering if anyone has any idea what the odds are. Given that 1 in 7 cis men (and presumably pre-HRT trans women) gets prostate cancer, it seems like if the odds were as high for post-HRT trans women, it would be known. Also, does anyone know how the odds of post-HRT trans women getting prostate cancer compares to cis women getting Skene's gland cancer? I read that Skene's gland cancer makes up 1 in 30000 female genital cancers, but that doesn't say what the odds are of cis women (and presumably, pre-HRT trans men) getting it (just the odds that, if a cis woman will get genital cancer, it will be in the Skene's gland).

 

Also, for the sake of trans men, it would also be worth asking what the odds are of post-HRT trans men getting Skene's gland cancer.

 

[Jani]

Dana I don't believe there has much study on this subject.  I am one of those 1 in 7 that got it and had it rectified years ago.  I would think (my opinion only) that taking estrogen would lessen the chances.  I've read anecdotal evidence that it shrinks testes so it might also affect this gland as well.

[Confused1]

1 hour ago, Dana Michelle said:

Does anyone have any idea what the odds are of transgender women getting prostate cancer? Prostate cancer runs in my family. I asked my endocrinologist and she said there has not been enough research to determine the odds. I wonder if there is at least anecdotal reports of what the odds are. Does anyone know? I found an article that said there have only been four reported cases of prostate cancer in transgender women, all of which started HRT after age 45 (I started at 36) https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00439-8/fulltext. However, there could be many more unreported cases.

 

I do plan to have prostate cancer screening once I am 50 years old, but I am still wondering if anyone has any idea what the odds are. Given that 1 in 7 cis men (and presumably pre-HRT trans women) gets prostate cancer, it seems like if the odds were as high for post-HRT trans women, it would be known. .

 

 

As Jani, I have had prostate cancer. I had the surgery to remove it and 2 years later ADT + radiation. It also runs in my family. I am not a doctor, but have talked to people on almost every English speaking prostate cancer website out there. I am on Lupron, which shuts down testosterone and estrogen, except from the adrenal glands. It causes both the testes and the prostate to shrink if you still have them. Odds of cancer should be substantially reduced at your age by HRT, but not to zero. I have no idea how it compares to Skene's gland cancer

 

Hugs,

Mike

[Jackie C.]

I've read that it reduces your risk, but as others have said, there haven't been a ton of studies. I couldn't tell you exactly how much.

 

We're hard to study considering that we're on the rare side and kind of reclusive. Like bigfoot.

 

Hugs!

[Rami]

This topic is something I am researching and I am in the process of discussing with the medical profession. I read somewhere on the internet, must be true,  that prostrate cancer in transgender women is extremely rare, in the magnitude of less than 10 per year? If true there are a number of explanations for this phenomenon. Transgenders die earlier of other causes before prostrate cancer comes into play and or HRT hormones slow down the progression of the disease so that other causes of morbidity comes into play.  I do not know if this internet rumor  applies to fully transitioned SRS transgender women or transgender women just on HRT? Given my advance age of 67 and just starting HRT this past March, family history of prostrate cancer,  both father and my father's father were dead at 72 from prostrate cancer related causes,  I am of the mind that the risk posed by HRT might  outweighed by benefits of HRT.  2 percent increased risk of stroke and DVT verses near certain prostrate cancer. I know that this a huge leap to think that being on HRT might be able to prevent prostrate cancer  given prostate cancer possible genetic component which might equates to inevitable certainty of getting prostrate cancer. My hairball unsubstantiated medical ignorant wishful thinking theory is that HRT hormones and blockers along with castration will slow down disease progression to the point where the transgenders dies from other causes before prostrate cancer come into play.  I suppose we could start by just looking  at transgender cause of death statistics and then compare them against other demographics to see if further investigation is be warranted. This is a subject for a  PHD thesis. 

[Jani]

Very interesting @Rami.  Best of luck with your thesis research.

 

Jani

[Confused1]

Hi Rami,

 

As a person who had prostate removed and salvage radiation 2 years later (this year) I will comment. Of course I am not an expert or doctor. I found out age 62 that I had almost the most aggressive cancer possible with a large part of my prostate involved. Many in my family have had this cancer, but never this young.

 

My point is this: If you have no cancer to start with, I think HRT might keep you from getting it or at least make it less likely. However, I had a pretty low PSA when it was discovered, so it is possible you could already have it and not know it yet. Just proceed with caution, although obviously most never have this problem.

 

I am on Lupron to shut down hormones for 2 years starting right before the radiation early this year. I had an endocrinologist ready to give me estrogen. My urologist won't give the OK for estrogen because he says it could cause my cancer to grow again if radiation didn't get it all. Lets just say that conversation did not go well during my last visit with him! I am still pretty bummed out. I told him I would wait for a little while, but if I didn't have estrogen soon after my hopefully upcoming GCS, I might have another doctor by then. YMMV

 

Hugs,

Mike