Testosterone after prostatectomy?

A friend of mine had his prostate removed 4 years ago and his PSA has been <.05 since his surgery. He has low T and his Urologist doesn't advised him against taking Testosterone. Is this reasonable? Is his Dr to cautious?

Your friend should do a little research on his own before his next conversation with his urologist...he can find the same journal info online that medical researchers publish for doctors. The medical community's understanding of TRT post-PC has undergone a paradigm shift; there used to be a blind fear that "testosterone might trigger some residual PC somewhere"...but general contraindication is largely debunked now and physicians also have a deeper understanding of the broader harms of hypogonadism.
But just because the new information is out there that doesn't mean every doctor is fully up-to-date. An informed patient is going to be the most satisfied with his treatments.

Here's a starting point:

• from the Renal and Urology News, 2018: "Testosterone Therapy Safe Despite Prostate Cancer History" https://www.renalandurologynews.com/aua-2018-coverage/testosterone-replacement-therapy-safe-for-prostate-cancer-patients/article/767232/
  
• from European Urology, 2016: "Testosterone Therapy in Men With Prostate Cancer" (by Kaplan, Hu, Mulhall, and others) https://www.europeanurology.com/article/S0302-2838(15)01213-0/fulltext

After 4 years, if his PSA using the ultra-sensitive PSA test is undetectable, then TRT is a possibility..If his surgery cured his cancer and he is cancer-free, then there is very little risk..Ask your friend what his "T" level is now ?

Steve,

I think Ed conflated "doesn't advise taking" and "has advised him against taking" and meant to say that the doctor was against his friend supplementing his testosterone.

Ed,

Urologists are slooowly coming around to the idea that T supplementation after prostate cancer treatments is OK for patients with low T if the PSA levels are good (undetectable after surgery and low and stable after radiation).

Many doctors have rules of thumb for how long they want to watch PSA after treatment before they OK T supplements, and often they want to wait a bit longer for patients at higher risk of recurrence. Your friend should ask his doctor how long he has to wait. That often leads to a more thoughtful discussion than just asking a yes or no question.

I started on Androgel in May of last year, six years after my prostatectomy. The urologist was unequivocal in saying it wouldn't present a problem. Within a couple months my PSA ticked up a couple hundredths of a point (from <.03 to .05), but it's been stable. Two urologists said not to lose any sleep over it, but we've been checking it more often. I think it's going to be fine.

I go to a urologist at Emory who’s billed as a specialist and expert in male reproduction, testosterone, prostate cancer, etc.

I’ve been taking the T gel under the arm for the past 12 months, and still my PSA has dropped down over that time to undetectable last week. She made me wait two whole years to try it but that’s my experience. My T is at 450 (it was like 170 pre T therapy) and I can bench press my body weight about 20 times at 52 yrs. old...... ;)

I got a second opinion from a Physician’s Assistant closer to home, and even thought my PSA had dropped consecutively they wouldn’t prescribe or recommend T for me.

I'm too late to the ball to add anything to this thread.

If anyone wants to go off on a TRT tangent, I'll drive. . .