SBRT with TRT, 8 Years Out

Well, last week was my 8-year post SBRT consult with my uro. Really it was just a visit to see how each of us is doing, as the medical issues of the past are currently unremarkable.

The "Cliff's Notes" version is that I was diagnosed in July, 2016, at age 68 with G 3+4=7, very low tumor load, very low percentage of G4. At diagnosis, my PSA was 5.69. I was long-term adult-onset hypogonadal, and had been on TRT (gel) for about 3-4 years.

With the advice and counsel of several members of this board, especially the Tall One (a former member who used the screen name of "Tall Allen"), I chose SBRT. Also at the recommendation of the folks here, I became a patient of Dr. Abraham Morgentaler (in Boston), who was/is the guru of all things related to the intersect of TRT and PCa. Dr. M worked with my uro and RO, and a treatment plan was developed that allowed me to continue TRT before, during and after treatment. I am still using the gel, with consistent results (T ranges from 600-1000, where normal is 300-1,100.)

At the time I was diagnosed, Allen claimed to hold the "record" of having the longest time-to-nadir of radiation patients, at 6 years. Well, I now claim that "award" as I am at 8 years and my PSA continues to decline, albeit now by smaller increments. From my reading of 5.69 at diagnosis, my PSA is currently at 0.12.

Side effects have been infrequent, but annoying. Not life-changing, as some have experienced, but I have had both rectal and urinary bleeding occasionally. Literally every time I had an incident of bleeding, however, was at a time when I was also taking an anticoagulent (often incorrectly called a "blood thinner") for a heart condition. I am not sure if I would have had such events had I not been taking Xarelto.

So, for those of you who are using or may need TRT, know that for some patients, it remains an option. I say "for some patients" because I felt confident using it due to my relatively modest/low risk level. Had I been a G- or 9, I do not know what might have been the case.

If you find yourself in a spot similar to where I was, don't panic. (I know, TRT patients may panic when faced with the prospect of losing the external T. I sure did.) Do your homework and see who is willing to work with you. You may be surprised at what can be done with the right patient and the right care team.

My heartfelt thanks to all the members here, current and past, for their support, input and advice. Without them, I might have found myself in a far worse place.

Good to hear from you Pax, and very happy that things are going well for you PCa wise.

On the subject of TRT, my RO (actually his NP) told me that after 5 years of undetectable PSA post SRT (I was a surgery patient), they would consider putting me on TRT if I felt I needed it.

I've actually had some thoughts about it, lately, for various reasons, with my T in the low 200's. Just a bit nervous about it, but considering it.

As I posted on another string, I recently (Sept) resumed TRT (gel). My dx was 12/29/2021, Proton RT (44x) Mar-May 2022. Eligard Mar 2022-Sept 2023 (I think, memory fading) and Zytiga June 2022-Feb 2023 (quitting due to mild stroke). PSA undetectable ( <0.02 ) until my recent test last week when it bounced to 0.04. I feel so much better having Test (at about 400 on most recent test), but the PSA rise is concerning obviously.