In the largest observational study so far, Sarkar et al. reported that men in the US Veterans Administration (VA) database who received surgery or radiation for localized prostate cancer and then received testosterone replacement therapy (TRT) for low testosterone were at no greater risk for recurrence than a matched sample of such men who received no TRT.
Here's an article about it:
thanks for posting this; it may be time for me to revisit this with my doc
I like what I read, except I am not sure what I read. I am waiting for someone to put this in street language.
That is street language. Ask questions.
I researched as much as I could with this sites assistance and presented it to my urologist students the Mayo Clinic in Rochester, Minnesota. Six months after my surgery for prostate removal and .01 test he approved my starting my testosterone again at a more limited dose. I went back to full dose two years ago. My surgery was 6 years ago. I continue to have .01 tests.
My T =17, the PSA is 1., down from 1.4.
Would it be OK if I started T?
No. This is only for men that have been treated for localized prostate cancer. Localized means the cancer was completely within the prostate and was curatively treated with either primary surgery or radiation. None of this applies to your case.
Thanks- TA
Thanks, Allen. Time for me to see Dr. Mills!
Is this fit to my father case allen?
Thnk alot
No. This is for men who have been cured.
I think it will be awhile before this would be considered after Tulsa Pro.
I agree.
Thanks for posting, TA! Any research being done with men with advanced PC?
No research. But you want to be sure your whole-pelvic radiation was curative before you start TRT.
Good morning TA. We’ve had a few conversations in the past before I got treated for localized PC last fall. Just came upon this post and wondered what you mean by curative. Was considering TRT and saw where you used curative as a prerequisite. Just to refresh your memory about my situation: Jan. 2020 PSA was 13. After Biopsy, found cancer in 12 of 15 cores. Two cores were G7 4+3 and two were 3+4. Tumor showed on MRI all within capsule. No extracapsular extension. By July, PSA was 18. Underwent 8 weeks proton radiation therapy in Jacksonville FL at UF Proton Therapy Institute Aug-Oct. Treated prostate bed, seminal vesicles and lymph nodes. Did not have ADT before or after proton therapy. Had 3 month follow up on Jan. 8. PSA was 3.5. Oncologist said we would monitor PSA every 3 months for two years to ensure clear. My T is currently 535. Seem to be losing muscle and have pain in legs. Thought some extra T could help me build back. Thoughts?
Your T is not that low. Consider the addition of strength training exercise and/or Peloton.
I had GL 4+3 with all appearing confined on MRI. Only after PSMA PET can you be assured you localized disease. UCLA suggests that in a similar case up to 30% will have disease outside the prostate.
I'd suggest you consider more than a single med onc opinion.
TRT increases PSA. So it will interfere with your diagnosis. How will you know if you are having a recurrence if your PSA goes up?
If your T is 535, you don't need TRT. Try exercising more (difficult now, I know). As I age, I notice it takes more work to get my muscles to just stay the same.
Thanks Tall Allen. I have exercised my whole life and the challenge of just not going backwards is the reason I was considering TRT. Probably not worth the unknown. I just saw the post that said TRT didn’t have an affect good or bad post definitive treatment so I thought I’d ask. How you are doing well. I appreciate your support for so many. David
just my two cents. I had an RP two years ago. Four out of 12 cores were positive and all were 3+4, but decipher suggested high grade so surgery was recommended. No evidence of spread beyond the capsule. After surgery, I went to a clinic outside of Boston, where I live, called Mens Health Boston. The clinic founder, Harvard faculty member Dr. Morgenthaler, has done much of the work in TRT post prostate cancer treatment. It’s interesting that at my cancer center, Dana-Farber, the head endocrinologist, an old timer, was stridently closed to the idea of TRT. But now, a year later, Dana-Farber is engaged in clinical trials using TRT on people like me and asked me if I’d like to be part of a trial. I told them I was already on TRT, and I wouldn’t consider a trial where I had a 50% chance of receiving a placebo but I’m glad they’re doing a trial, since In their opinion the existing research isn’t strong enough to support TRT—so good for them for admitting that TRT might have a role for many men post treatment and doing their own research to confirm this (and getting the credit that they are denying to others who have studied and concluded that it is beneficial for many).
Long story short: I started TRT about eight months after surgery. PSA was undetectable, and remains so – I had it tested every three months, and was just told by my surgeon that I can be tested every six months now. TRT has had huge benefits. Yes, libido is stronger, and ED improved but still not back to normal. Most important for me though is the boost in energy, ability to maintain muscle, even skin tone/elasticity appears healthier.
IMHO, if you’re a candidate, find a urologist who will support you.
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