TRT after Prostatectomy

[radioradio]

I had been on TRT for about 15 years prior to my PCa diagnosis in January, and life was good. That was stopped immediately by my docs. So now my T is anywhere from 50 to 150. Practically castration level. My ultra sensitive PSA's at 3 months and 6 months were both <0.006.

My GP, my regular Uro, my endocrinologist, a local endocrinologist and a local uro are all against me resuming TRT. My RP surgeon and my implant surgeon both say I'm fine and should re-start the TRT to address the symptoms and side effects of low T and get back to a better quality of life.

So a few questions...

A. Has anyone here either started or resumed TRT after a prostatectomy?
B. Anyone have anything to share about this?
C. Can anyone recommend a uro or endocrinologist in the Philly area who is not wedded to the long-standing (but seriously challenged by many) doctrine that TRT is contra-indicated in my case?

Thanks.

Bob 2.2

[bldoink]

A) Yes. I started therapy about a year ago on the advice of my GP.

B) I didn't have a uro at that time as mine had retired. My hormone levels were bottomed out like yours when my GP started me on the therapy. Well my GP left and I found another uro. Before seeing him he required all of my medical records. When I saw him he took me off of the TRT immediately. He advised that he had recently been at a conference and the consensuses is still that prostate cancer survivors should never be on TRT, even with non detectable PSAs. He agreed that there was some dissent but that it was a small minority. He further stressed that as my cancer was (I forget the correct term) in the margins such dissent didn't apply to me anyhow and I should never be on TRT no matter the PSA.

C) No

[radiodec]

I am not surprised that most urologists say NO to the TRT. One of the first line chemo-therapies used on recurrent prostate cancer is androgen blockade, essentially forcing testosterone to 0 to take out the cancer cells that are testosterone sensitive. It sounds like with very low T you are getting the treatment without the chemo.

David

[Frank Talk Admin]

Sounds like your doctors are following outdated protocol. The AUA and the SMSNA both have changed regarding TRT following PCa. If you are cancer free, you should be fine. Find a uro that specializes in mens sexual medicine or at least TRT. Remember, urologists are just taught to cut - they are surgeons. They don't get training in hormones.
I have been on TRT for years following RP.
Paul

[radioradio]

Sounds like your doctors are following outdated protocol. The AUA and the SMSNA both have changed regarding TRT following PCa. If you are cancer free, you should be fine. Find a uro that specializes in mens sexual medicine or at least TRT. Remember, urologists are just taught to cut - they are surgeons. They don't get training in hormones.
I have been on TRT for years following RP.
Paul

Thanks, Paul.

It's frustrating. Docs won't tell you up front if they're open to this. I have an appointment schedule with a doc at Penn, referred by the surgeon who did the prostatectomy, so hopefully he'll be on board. But I won't know until I drive to Philly and go through the "new patient" dance in two weeks.

Bob 2.2

[bldoink]

Paul, any chance of links to papers on the subject? I would very much like to resume the therapy if not contraindicated, especially in my case with the cancer being in the margins. My PSA has remained good. I have a new to me, but not young uro that seems good but I haven't formed a final opinion on him.

[Larry10625]

I had been on TRT for about 15 years prior to my PCa diagnosis in January, and life was good. That was stopped immediately by my docs. So now my T is anywhere from 50 to 150. Practically castration level. My ultra sensitive PSA's at 3 months and 6 months were both <0.006.

My GP, my regular Uro, my endocrinologist, a local endocrinologist and a local uro are all against me resuming TRT. My RP surgeon and my implant surgeon both say I'm fine and should re-start the TRT to address the symptoms and side effects of low T and get back to a better quality of life.

So a few questions...

A. Has anyone here either started or resumed TRT after a prostatectomy?
B. Anyone have anything to share about this?
C. Can anyone recommend a uro or endocrinologist in the Philly area who is not wedded to the long-standing (but seriously challenged by many) doctrine that TRT is contra-indicated in my case?

Thanks.

Bob 2.2

I think I would want to know why all those doctors are opposed to it. Did you tell the surgeon that all the others say not to use it? I hope he's willing to prescribe it. I googled low T before and there are other complications to having low T than low or no sex drive. Check it out.

Larry

[radioradio]

I had been on TRT for about 15 years prior to my PCa diagnosis in January, and life was good. That was stopped immediately by my docs. So now my T is anywhere from 50 to 150. Practically castration level. My ultra sensitive PSA's at 3 months and 6 months were both <0.006.

My GP, my regular Uro, my endocrinologist, a local endocrinologist and a local uro are all against me resuming TRT. My RP surgeon and my implant surgeon both say I'm fine and should re-start the TRT to address the symptoms and side effects of low T and get back to a better quality of life.

So a few questions...

A. Has anyone here either started or resumed TRT after a prostatectomy?
B. Anyone have anything to share about this?
C. Can anyone recommend a uro or endocrinologist in the Philly area who is not wedded to the long-standing (but seriously challenged by many) doctrine that TRT is contra-indicated in my case?

Thanks.

Bob 2.2

I think I would want to know why all those doctors are opposed to it. Did you tell the surgeon that all the others say not to use it? I hope he's willing to prescribe it. I googled low T before and there are other complications to having low T than low or no sex drive. Check it out.

Larry

I know. I've dealt with them (complications) for years. It all goes back to a study in 1941, believe it or not, when it was found that eliminating testosterone in prostate cancer patients halted/slowed the growth of the cancer. The thinking was that if eliminating it stops it, than its presence must be feeding it.

Since then so much has been learned about the mechanisms by which T really affects prostate cells. It's even become an acceptable therapy (for prostate cancer treatnent) to actually lower then raise T in cancer patients.

I'm hopeful the doctor that my surgeon recommended will be more "new school".

Bob 2.2

[Larry10625]

I had been on TRT for about 15 years prior to my PCa diagnosis in January, and life was good. That was stopped immediately by my docs. So now my T is anywhere from 50 to 150. Practically castration level. My ultra sensitive PSA's at 3 months and 6 months were both <0.006.

My GP, my regular Uro, my endocrinologist, a local endocrinologist and a local uro are all against me resuming TRT. My RP surgeon and my implant surgeon both say I'm fine and should re-start the TRT to address the symptoms and side effects of low T and get back to a better quality of life.

So a few questions...

A. Has anyone here either started or resumed TRT after a prostatectomy?
B. Anyone have anything to share about this?
C. Can anyone recommend a uro or endocrinologist in the Philly area who is not wedded to the long-standing (but seriously challenged by many) doctrine that TRT is contra-indicated in my case?

Thanks.

Bob 2.2

I think I would want to know why all those doctors are opposed to it. Did you tell the surgeon that all the others say not to use it? I hope he's willing to prescribe it. I googled low T before and there are other complications to having low T than low or no sex drive. Check it out.

Larry

I know. I've dealt with them (complications) for years. It all goes back to a study in 1941, believe it or not, when it was found that eliminating testosterone in prostate cancer patients halted/slowed the growth of the cancer. The thinking was that if eliminating it stops it, than its presence must be feeding it.

Since then so much has been learned about the mechanisms by which T really affects prostate cells. It's even become an acceptable therapy (for prostate cancer treatnent) to actually lower then raise T in cancer patients.

I'm hopeful the doctor that my surgeon recommended will be more "new school".

Bob 2.2

Do you still have CA of the prostate or are you clear now?

Larry

[radioradio]

Readings at 3 months and 6 months <0.006 Considered "undetectable".