New post-radiation PSA result after starting TRT

Well, my take on it is surprise that with G8 (or G9 depending on who you believe) your oncologist is okay with TRT. Is it a radiation oncologist or medical oncologist? If the latter I would be even more surprised. TRT for someone with a G8 or G9 isn’t unheard of, but I would think more time needed to pass before the okay.

As far as the PSA test, going from 0.02< to 0.04 would be concerning to me, even though it doesn’t seem like much, you have to consider the TRT likely is a factor.

Hard to know what just happened for sure. You had not been off of ADT for very long and you just recently started TRT. It could have been destined to happen without TRT which may have just hurried up the process or be a coincidence.

You also have the common issue with RT where PSA tends to play the long game before it stabilizes and you never know what your PSA variances mean until some years later. A PSA of 0.04 is tiny and could be the result of almost anything, even lab error. Maybe the TRT poked some dying cells that celebrated then died with a hangover.

So no, it does not mean much at this point. Your mental well-being has to be considered in these decisions so your doctor should be sympathetic and try to work with you on solutions.

Sailor, you are correct. I still have a prostate. I assume it's kinda burned up (I'm thinking charcoal, but prob not) from 44 radiation treatments. But, I never had any kind of surgery to remove it. And interestingly enough, when we recently gave a it shot at an intimate moment after my Tri-mix injection, my wife said she saw a bit of some kind of discharge. (Bad word choice as "discharge" sounds infectious.) I didn't dare want to suggest it might be urine. So, IDK?

BTW -- Doc's office said NBD. They won't pursue anything until (IF) it reaches 0.5 (not 0.05).

Admittedly, this result is disappointing. At least I do not think it has been as alarming to me as the original dx. I'm actually considering retiring (again, it was a HORRIBLE decision at 55 yo) as I'm 69 yo. Plus, physically I am feeling better the majority of the time. Being on ADT was intolerable. I am still weaker than before my dx and I need to start a workout routine. While I struggled to keep the weight off, I've actually lost a few pounds at this point, but everything sure is redistributed differently as muscle mass noticeably deteriorated while doing ADT.

So, I guess it's the same old "wait and see" what the next blood test is. You gents that have been posting on here 10 years or so are the greatest encouragement. It's clear you're still active and still enjoying life. Thanks for being here!

I posted this on the string re: TRT but probably should have done so here. Sorry if you have a deja' vu moment from reading it twice.

LAB RESULTS UPDATE (12/20/2024):
Total Testosterone: 603 (Using 2 pumps/day of Androgel 1.62%)
PSA: 0.07
So, that is the 2nd increase since quitting ADT and restarting TRT (from undetectable <0.02 to 0.04 to 0.07)

Saw the oncologist NP (kinda unhappy I didn't see the doc, but I assume she was made aware of the new test result). NP said NBD. Totally unconcerned. Continue to retest every 30 days.

Saw the endocrinologist who gave the Test Rx and he was also unconcerned at this point with the gradual increasing PSA results. He specifically inquired if I still had my prostate or if I had had it removed. Since I still have it (after having radiation - no surgery), he said he is not surprised to have a bump in my PSA as starting TRT does that and that I still have prostate tissue. Yes, we will watch what it does and concurred to testing every 30-days.

Noteworthy is that even my (adult) sons have all commented that I must be feeling much better as I have more energy and I am doing more. I've done a couple projects at home and my wife & I just took a long weekend in Cancun.
Also, noteworthy (at least to me) is my libido has "bumped up" too though that does not mean things are working the same as in the past. My "size" is at about 50%. Atrophy? My erection is also only about 50%, but with using the TriMix Rx injection (ouch) penetration was possible. Not shouting from the rooftop yet, but hopeful. I have even had a mild orgasm and even small amount of "ejaculate" (though I'm afraid it is maybe urine(?) vs actual ejaculate - since I doubt my radiated coal lump of a prostate surely cannot produce anything).

Sorry if that's TMI, but this is (or at least was) an important part of our lives that this damn disease and its treatment has stolen from most of us. After having things inserted everywhere (often with an audience) to implant markers, taping my junk to my belly to get it out of the way, checking for bladder cancer, demonstration of injecting TriMix, etc etc I just would find it hard to believe that anyone might still get squeamish about discussing these things.

YMMV

What lab did your PSA test? Was it Quest?

I sound like a broken record but I will repeat that I have been on TRT throughout treatment and after.
PSA at 0.6 was as high as 7.4 at one time but after Greenlight laser it went down a lot.
my Gleason was all G6 except one core was upgraded by John's Hopkins to G7 so yes sorta low grade but high volume.
emotionally I cannot deal being off TRT I have tried for at least 8 months when first learning about the PCA
But I was a basket case. For those on ADT I feel for you all. Glad I was lower grade PSA

I by the way do not believe the T feeds the PCA or at least as much as has been said.

Happy New Year!

Glen

Jack,
I am hoping they can get Bipolar Androgen Therapy worked out well before I need it. I think BAT is very exciting along with Pluvicto for future PCa management. BAT currently is working for 30-40% of men. Pluvicto has variable success too. Hopefully, the kinks can be worked out for both. The VERY interesting thing about BAT is that it resensitizes The cancer to be vulnerable to Xtandi (Enzalutamide) again. So, that is a powerful combination. After the Xtandi wears down, slap the cancer cells silly with a round or rounds of BAT. Most of the remaining PCa cells are vulnerable to Xtandi. Repeat the cycle as needed.

This isn’t just theoretical stuff. It has worked on many men, but there is a lot of fine tuning left to do.

Isit, sorry I have those two readings and don't understand them
My Testosterone is running over 800 but my clinic likes it high as long as the other hormones are in check which they are.
He prescribed for how I feel rather than just numbers.
By the way I completely understand why you want to be on TRT and I agree. Apathy is a good way to explain the feeling of low testosterone along with depression and constant mild to moderate anxiety.
So yes I took the risks and it's paid off.
Yes I was not high grade but I did have a lot of volume so there was some risk.
Couple of weeks and I'll have my Long overdue colonoscopy.
Been over twenty years. I know not smart.

Glen

I forgot to thank you Jack.
I'm confused over all the studies and thoughts on TRT and understand that each study may be slanted for a certain result.
All this aside I'd repeat that for me life without TRT is just too much for me to take.
Low energy apathy anxiety and the like ruin's it.
I suspect that even with a higher grade PCA I'd still take TRT

Glen