TRT after prostatectomy

[Bruce K]

Glad to hear your surgery went well.

Does not help your situation of having to deal with low T.

Healthy testosterone levels are critical to men's health/overall well-being.

Although the use of PDE5i will enhance/improve erectile function underlying vascular health is critical let alone healthy T levels are needed to experience the full beneficial effects.

Testosterone and more importantly its metabolites estradiol and DHT are critical not only for libido/erectile function but overall health (brain, cardiovascular, bone, metabolic, immune system, body composition).

Definitely, a big decision when it comes to hopping back on trt.

I have posted numerous threads on here regarding testosterone/prostate.

Here is one of the more recent papers.

Testosterone Therapy After Prostate Cancer Treatment: A Review of Literature

ABSTRACT Introduction: Although testosterone therapy (TTh) is the standard practice in otherwise healthy hypogonadal men, this therapy has historically been contraindicated in men with a history of prostate cancer. Recent evidence suggests that there is minimal or no prostate cancer growth in...

www.excelmale.com

I have read everything you posted on prostate cancer. I truly appreciate everything you do for this forum. I can't even imagine how much time you put into finding/posting all this information. Your posts help me more than you'll ever know. THANK YOU

Since I've been off T my mind and body have definitely suffered. I'm a 100% believer in T. All I can do is stay positive and hope everything works out.

 

[madman]

I have read everything you posted on prostate cancer. I truly appreciate everything you do for this forum. I can't even imagine how much time you put into finding/posting all this information. Your posts help me more than you'll ever know. THANK YOU

Since I've been off T my mind and body have definitely suffered. I'm a 100% believer in T. All I can do is stay positive and hope everything works out.

Thank you for the kind words.

Stay strong you will get through this!

 

[tcmi]

Thank you for the kind words.

Stay strong you will get through this!

My regular urologist, who is not the doc I see for TRT (but is generally supportive of TRT), wanted me to stop testosterone completely prior to surgery and then evaluate six months after surgery (to make sure PSA was near zero). I think that was a pretty reasonable approach.

However, I next went to Memorial Sloan-Kettering Cancer Center in NYC and saw a prostate specialist / surgeon who also follows over 2,000 patients on Active Surveillance. He told me there was no need to stop the testosterone - as long as I was at reasonable levels (ie, not crazy high). As long as nothing unexpected is found during surgery, I can continue with the TRT post surgery. Working with the male sexual health practice at MSKCC, I think they genuinely weigh any potential cancer recurrence (which is very low) against all of the other health risks of having Low T. It’s a calculated risk, and one I’m comfortably willing to take - especially when I know I’ll be closely monitored going forward.

The good thing about surgery (assuming the cancer is contained within the prostate) is that the PSA test becomes an excellent cancer indicator - without a prostate, you should pretty much be at zero. If your PSA begins to rise again, you know you’ve got a problem. With that kind of reliable indicator, it makes a decision to resume TRT much less risky. Going the radiation route (as opposed to surgery) doesn’t offer the same comfort in monitoring.

 

[RLewis]

I ran across this thread and hesitated to post a reply because of the range of outcomes and expectations. I'm 62 and had a prostatectomy 16 years ago. I started TRT about 8 years ago, first with injections and for the last 5 years with pellets. I still pump 4 to 5 times per week and while I had pretty good results from Cialis my ability to sustain an erection became a problem in the last 2 years. I take 5mg of Cialis daily and 20 mg prior to sex. I started using Aprostadil injections in place of the 20mg Cialis on occasion and the results have been phenomenal. The real issue for me has become the testicular shrinkage as a side effect of the TRT, and I sought out and was just prescribed HCG to address it. I spoke with 2 physicians as I was naturally concerned about any role that it might play in feeding any cancer cells that might be hanging around, even though the biopsy of my removed prostate indicated that it was fully contained. I get my PSA checked every 6 months and it remains undetectable after 8 years of TRT, so their opinions were that it would be highly unlikely that the HCG would cause any change in my cancer status. The physician that prescribed the HCG is also recommending that I try Vardenefil-Aporphomine. So in closing 2 questions: 1. anyone have experience with HCG post-prostatectomy? and 2. anyone have experience with Vardenefil-Aporphomine? Thanks - RLR

 

[Bruce K]

I started TRT a month ago. I couldn't find a local doctor to prescribe it to me so I went underground to get it. I don't recommend it but that's what I did. I feel so much better now. I'm on T only. No HCG and I know nothing about Vardenefil-Aporphomine...

I'll get labs done in a couple of months and hopefully my PSA stays undetectable.