RT, RP and TRT

A shearing client of mine was recently diagnosed with PC 2 pos cores of 12 1 grade group1, one grade group 2. He is currently on TRT. His uro told him that he can resume TRT one year after RP, but never after RT...without ADT, I think. Is this the current thinking? He asked the uro..a surgeon, why and he said "trust me". I guess Matt accepted that.

New for me as well. Didn't realize sheep were susceptible to PCa.

2013 Total T level 9, 2014, 400 up to 587, since then dropping every year, now 299. Asked my RO about TRT, and the answer was, "not recommended due to your history of prostate cancer"

This from a well known RO

Sorry - but once again, I'm an outlier. I have been on TRT for about 6 years now. . . before diagnosis, during SBRT, and continuing after. I consulted with Dr. Morgentaler (in Boston) about this, as he has spent much of his last 20 years or so researching the intersects between TRT, testosterone and PCa. His position is documented in many published works, but the one I hang my choices on is the Saturation Theory.

This theory shows that as long as your T level is above castrate level, increases or decreases in your serum testosterone level will have no significant effect on the development, growth or progression of PCa. Prostate cancer cells only need a small amount of T to "do their thing." So, as long as the patient's diagnosis does not require elimination of T, then why deprive him of this necessary hormone when there is no medical benefit to doing so? Also, and a very important point, is the fact that your prostate and your prostate cancer cannot tell the difference between T manufactured within your body and T purchased at the pharmacy. T is T.

So, long story made short, with Dr. Morgentaler's input and cooperation, my RO and local uro are managing my TRT all through this journey. Since I had radiation, I do have to accept the fact that there could be some noise in my PSA readings, but really, if the body cannot tell the difference between naturally produced and store bought T, what difference could there be? I guess there could be a measurement bias introduced if the patient's TRT was not a daily dose, as there could be spikes with periodic injections, but since I use a daily gel, the dose is consistent from one day to the next.

We each have to make our own choices, but if your client is in a low to favorable intermediate risk category, he should consider continuing his TRT. If his doctors will not consider this, he might be well advised to consult with other doctors before making his final choices. (Dr. Morgentaler is quite accessible, if one is willing to travel to Boston to see him.)

I really struggled with this when first diagnosed, as I was badly symptomatic (adult onset hypogonadism) prior to starting TRT, and just couldn't accept having to go back there unless there was a solid medical benefit to doing so.

NOT a nuanced guy ,that is