Testosterone Vs. Testosterone Replacement Therapy

[JWS13]

Need Feedback please RE: Natural Testosterone & TRT

Just spoke to my MO (a very well known Oncologist -here in LA) about my Testosterone.

Have been off Orgovyx now for 4 & half Months.

Latest Blood labs are Testosterone 79.

Oncologist says T probably will come back to 103 but not higher and I should start TRT therapy. He also says that he will "guarantee " that using TRT will not bring on a reoccurrence."

Would you wait a couple of more months to see if natural T comes back to baseline of 279(pre PC diagnosis. ) or would you risk (he says no risk) the trt therapy for rest of your life?

does anyone know if he is correct and natural T won't be coming back?

What are the Side effects of taking the GEL T besides watching for "THICK BLOOD & CLOTS?"

I don't want to get into another rat's nest here?

Thanks for all your responses..

62, psa -8, psma-no mets, imrt- 20 tx, gl 4-3 orgovyx -4 months ended may 31 2023.

[Tall_Allen]

What was your T level before Orgovyx?

Radiation therapy can sometimes have a temporary depressing effect on T:

prostatecancer.news/2016/08...

I wouldn't worry that T will cause a recurrence if your IMRT was curative:

prostatecancer.news/2020/06...

However, PSA is your best tool for monitoring recurrence, and it is way too soon to declare yourself cured. Taking T now will raise your PSA and interfere with your monitoring. How will you know whether an increase in your PSA is a benign reaction to T, or whether the radiation did not cure you?

My RO did not object to TRT for me, but recommended I wait until I have very low consistent PSA for a couple of years. This is stuff your "well-known oncologist" probably doesn't consider because it is not his job to treat and follow patients who've had radiation. I recommend you discuss this with your RO and not your "well-known oncologist."

[JWS13 in reply to Tall_Allen]

my t level before orgovyx was 279.

[ElizabethMedora in reply to Tall_Allen]

"Taking T now will raise your PSA and interfere with your monitoring. How will you know whether an increase in your PSA is a benign reaction to T, or whether the radiation did not cure you?" Exactly what I'm wondering about my husband right now! After finishing all his treatments including his course of ADT, he waited about a year and his T only went back up to 80. During that time, his PSA was consistently .02. He was feeling really crappy so Dr. Scholz recommended TRT, it's been about 9 months and his T is now 850 and he feels great. But as soon as he started TRT, his PSA jumped to .06, then 3 months later to .2 and then 3 months later to .4. Still very low, but Dr. just ordered a new PSMA scan. Yeah we're nervous, but it makes sense that this is likely related to the TRT considering how stable he was post-treatment, right? I'm looking for best-case-scenario probabilities here! Feedback appreciated.

[Tall_Allen in reply to ElizabethMedora]

His doctor interfered with his diagnosis, and I have no idea what he can do about it now. PSMA may show nothing, but that is meaningless, or it may show "zombie" cancer (it's dead in its DNA but hasn't been eliminated yet). I think he has to get off TRT and find a new MO.

[ElizabethMedora in reply to Tall_Allen]

Thanks for the input. When you suggest he has to get off TRT, is that in order to watch the effect on PSA, or because it could be stimulating nascent cancer cells? Or both?

[Tall_Allen in reply to ElizabethMedora]

Both. You have no idea why PSA is increasing..

[Justfor_]

They say that low T before diagnosis is not a good prognostic factor, i.e. your 279 T places you in a higher risk category than envisaged by your GS. For a additional, but totally different reason, I wouldn't hasted resorting to exogenous T. Human body is kind of lazy. When some body function gets external assistance internal effort is lessened. Typical examples of this are: a) Insufficient kidney function that gradually after starting dialysis worsens and before long kidneys stop functioning alltogether. b) Children of short stature that receive recombinant (artificial) human growth hormone. They have to get it until their adult height is established, else any gain in height will be lost during the years that it takes the body to get back to its normal state. For these reasons I would waited at least one year before resorting to exogenous T.