I understand your concern about testosterone and this was the prevailing opinion several years ago. But, thinking regarding TRT and prostate cancer is changing.

I was diagnosed with G9 prostate cancer in 2021 at age 68. Had RP with subsequent development of oligo metastatic disease treated with SBRT, triple therapy and whole pelvic radiation. I was on Lupron for only a year. My PSA became undetectable after second chemo/taxotere cycle and has remained so for >2 years. My T never rebounded after discontinuing the Lupron. I had the usual side effects related to low T.

Around 5 months ago my MO said he wanted to put me on TRT under the guidance of an endocrinologist. My MO is very experienced and has been treating prostate cancer for decades. He is at Johns Hopkins and is the Director of the Brady Urologic Prostate Cancer Research Center. He has published >500 articles on various topics related to prostate cancer. I trust his judgement completely.

Taking TRT is an individual decision between the patient and their physician. There are pros and cons, like everything in life. Medical decisions are about weighing risk vs reward. But to say patients with a history of prostate cancer (even metastatic) should never be put on TRT is incorrect.