SBRT - 2 Years Out. . . WITH TRT!

Just thought I'd post an update on my progress after SBRT for G3+4=7 PCa. I've been active here on other PCa topics, but really haven't written much about my progress in the recent past.

For those who haven't followed my past threads, I have been using TRT (testosterone replacement therapy) for the past 6 years -- before diagnosis, during treatment, and now after treatment. I was so miserable before TRT that I couldn't face the prospect of stopping it because of the cancer, and I was lucky enough to have a favorable intermediate risk diagnosis and some very wonderful, open-minded doctors. I won't re-publish the whole story of how I got to where I am now, but those interested can search my early posts here on HW to read it.

What I do want to publish now is the progress I've made. I'll just post a list of dates, PSA readings and T levels.

DATE PSA T notes
2012 1.20 199 Pre-diagnosis, T had also been as low as 133
2013 3.19 696 shortly after start of TRT - we attributed PSA rise to T rise
05/16 5.69 920 biopsy shows G3+4=7
11/16 SBRT completed 11/23/16
01/17 4.78 451
04/17 3.03 570
07/17 2.86 901
10/17 2.15 113 blood draw before daily T dose
01/18 3.02 796
10/18 1.93 684

We considered the 01/18 reading to be a bounce, and just went about our merry way. Now, seeing the October 2018 reading, I am (still somewhat cautiously) optimistic.

I am posting this not only to indicate my slow, bouncy progress after SBRT, which some of the studies have shown to have good prognosis for favorable long-term outcomes, but to also show that it can happen even if you need to continue TRT through and after treatment.

This is most definitely NOT to say that TRT is advisable for all. From the advice I received from my doctors, continuation of TRT is ONLY potentially advisable for patients whose initial diagnosis would not have driven ADT to become part of their treatment. If a patient's initial diagnosis requires ADT as part of the Standard of Care, then this is probably not for them.

I don’t recall seeing many guys here treating PCa and low testosterone, for obvious reasons. But it seems to be working well for you. I hope it continues.

Congrats on progress!

Bob - You don't state where you are located (Elkridge, NV?), but the only local docs I've worked with are near Chicago. You could try contacting the office of Dr. Abraham Morgentaler, in Boston. He is the doc under whose direction my local docs are managing my TRT and PCa treatment. Dr. Morgentaler has spend his last 20 years researching the intersect between testosterone, PCa, and TRT. His office may be able to give you the name(s) of doctors he has worked with for PCa patients needing help with TRT.

You could also ask your local uro if a written consultation from Dr. Morgentaler would allow him (local doc) to proceed with your TRT. That is how my RO and Uro are working at present. I made an appointment and went to Boston to see Dr. Morgentaler. After taking my medical history, interviewing and examining me, Dr. Morgentaler wrote directly to my local doctors, offering his opinion and recommendations. (This way the communication is "doctor to doctor" so there is no hint or possibility that the patient has any control over what is said.)

With your G6 biopsy findings, I would imagine that Dr. Morgentaler would see no reason to withhold TRT in your case -- after all, the standard of care for your diagnosis does not include ADT, so why withhold T from you? Your body cannot differentiate between T that it makes internally and T that you purchase at the drug store.