I know HT is a sensitive topic and you aren't exactly looking for input (although you are looking for something).
So I'll just put out there, in the event your doctor, or you, decide HT does merit consideration:
Before diagnosis, my husband was in severe, chronic pain. He was also losing weight, despite stopping physical activity and not changing his eating habits (except maybe for the worse -- he was depressed, he was largely immobile, which lends itself to more unhealthy eating, late night snacking, etc.).
His PSA was around 40 when first tested, as part of a "why won't my back pain go away" doctor vist. In other words, your neighborhood.
He started HT and within two weeks was virtually pain free. His diagnosis is serious and I dreaded telling our boys (11, 9, 7). But in truth it's gone really well with them, because he is so much better than he was before the idea of cancer entered our lives. The word scared them, but as my oldest, most anxious kid told me -- "I was scared at first, but he is back to being himself again." I honestly thank god and big pharma that HT exists.
I know you hope to avoid HT, and given that, I hope you do, too. But if it starts looking necessary, I hope it does for you what it did for us.