I was diagnosed with G9 at age 68, right about retirement. Had RP. Six months later I had PSA rise with PET scan showing met at T8. Treated with local (SBRT) radiation. Four months later PSA again rises significantly with another PET scan showing new pelvic node. Went to Johns Hopkins and had triple therapy Lupron for one year, Darolutamide for 3 months, and 4 cycles of Taxotere). PSA went immediately undetectable after second chemo session and has remained so for 2 years.

My last 3 month Lupron shot was July 2023. I experienced all of the usual side effects of low T- fatigue, low libido, loss of muscle, depression etc. My T did not recover (last test was September and T was 52). My JH medical oncologist said I needed to have testosterone replacement therapy (TRT) as I could not continue long term with markedly depressed T. I saw an endocrinologist and was placed on Androgel. I had labs drawn yesterday. T now in high normal range, 845. PSA remains undetectable. My low T side effects are slowly starting to subside.

TRT in men with history of prostate cancer (especially metastatic -oligo-disease) remains highly controversial. But there are known long term deleterious side effects from low T aside from fatigue, depression etc. Some oncologists may be very reluctant to put their patients on TRT as the T may fuel cancer. I have the utmost confidence in my experienced, knowledgeable oncologist at JH. The TRT isn't for everyone.