Before I was diagnosed with PC in 2008, for about 10 years (since about age 50 I think) I'd been using a prescribed testosterone cream after learning my T counts were low -- like low 200s, still within "normal" range but evidently not normal for me because I was depressed, with no energy, no desire to do anything, no sex drive, symptoms that began imperceptibly but gradually deepened over time. Ever since my teens, I'd had a varicocele in one testicle that no doctor ever thought to do anything about, and over the years it had gradually strangled it until it atrophied (the doctors now say it's too late to fix it), and my T count had dropped accordingly, much more than it should have with normal aging.
Well, the T replacement changed my life, and for the first time in a long time I actually cared about things, had energy, gained strength, felt better about myself and life...and found a wife, and developed a wonderful love life. And only two years after we married, I got the PC diagnosis. Had to stop the T cream. After my first HIFU treatment, my doctor grudgingly allowed me to resume, but the PC began growing again - he said it was obviously activated by testosterone and I had a choice to make - stop the T and contain the cancer, or continue the T and risk metastasis. I chose to stop the T.
And over the succeeding years, my depression (which actually began in childhood - that's another story), lack of vitality and lack of caring about anything returned. I tried to remain physically active - I'd always surfed and bicycled and lifted - but gradually arthritis robbed me of the ability to do those things, and even walking for any distance was painful. I lost interest in sex, much to my wife's chagrin, but she has stuck by me nonetheless, and every day several times a day I feel so bad about how I've lost desire for her (and everything else).
So now I'm 75 - I've never had metastasis, my HIFU-ravaged prostate is half gone and my PSA seems stable at 1.5 (maybe it would be 3.0 if it were a whole prostate?). For a while I wondered if maybe I didn't even have PC anymore, but a rise in PSA from 0.6 to 2.2 in about 6 months in 2019 led to an Axumin scan that "suggested" PC activity that was hard to discern for certain due to such heavy scarring from HIFU.
But I feel so bad all the time now, and when I think back over the past 14 years, and review my gradual decline to this state of overwhelming sadness (only an antidepressant keeps me from suicide), I wonder if it was worth it to stop the T in fear of metastasis. Of course I know I would not have wanted metastasis far more than I wanted a normal testosterone life, but still...it's hard for me to imagine having to live the rest of my life in such misery.
And so I wonder if it's worth it to risk resuming T replacement. I know it wouldn't help the pain of disabling arthritis, but it would help my outlook on life, give me some hope of being able to love life again. My new doctor suggests I could try DHEA, but I've read conflicting things about whether it raises T levels or not. I've read some things here, mainly in Advanced PC forum, about high doses of T working wonders without regenerating PC, but those are for men with advanced PC who have gone through the wringer of treatments and been in far worse shape than I've ever been. I feel like I'm in some ambiguous middle ground where there are no straightforward answers simply because my PC situation has never become so drastic and life-threatening. I don't know that any doctor would even prescribe the stuff for me.
But...well, I'm just thinking this out as I write, trying to figure out how I feel. Sorry for droning on, and if you read this far, thanks for reading. Any insights would be much appreciated.
Should I consider HIFU for Gleason 7 (4+3)?
Post radiation and low(er) testosterone
Northern California HIFU
