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@kenk1962 My treatment was similar but I got 40 Gy. My testosterone hasn't recovered much a year after stopping Orgovyx (220 vs. ~550 pre-treatment) so next month I have a meeting with my oncologist. I'm starting to develop metabolic syndrome from low T (osteoporosis, high cholesterol, pre-diabetes) plus all the negative mental stuff from while I was on ADT is returning.

Oncologist, sexual health doctor and endocrinologist are recommending raising my T to 400-450 to help me feel better, get cholesterol under control, etc. My GP and urologist are dead set against this saying it's unproven whether this is safe.

I have a month to decide. I'm leaning towards doing this because my PSA is low enough that I have some wiggle room so that if it starts to rise I can stop, but I have mixed feelings. It would be GREAT to finally start to feel normal again but I also don't want to cause the cancer to start growing again. I know what you mean about needing T to work--I had to quit my job as a data analyst and can barely concentrate on anything anymore, though going on meds has helped.

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Replies to "@kenk1962 My treatment was similar but I got 40 Gy. My testosterone hasn't recovered much a..."

@scottbeammeup Well that is the real question, isn’t it? If SBRT was successful, WHY would your cancer recur? If there was no spread and the radiation/ADT killed it all, shouldn’t you be ‘cured’?
Seems to me that a younger man - which I think you are - should go for TRT. Are you supposed to endanger your longevity with all the maladies incurred by low T? Should you begin 3 different meds when one simple hormone will do?
I realize that I am not in your shoes and it’s easy for me to say ‘go for it’ but wouldn’t you want to know definitively if you can start leading a normal life again?
Just my thoughts…pay NO attention to that man behind the curtain!

@scottbeammeup You're facing the classic post-PCa treatment dilemma.

If this were a pre-2015 year I suspect everyone - your oncologist, sexual health doc and endocrinologist - would all oppose any TRT. That's just the way it was.

However...it's 2025 and there have been many favorable studies during the last 10 years on varying applications of testosterone for PCa patients. My recommendation would be to do two different types of AI research during the next several weeks on this issue:

- One AI research question should include everything in your PCa background and statistics. Provide lots of details that are particular to you. Then ask the question, "Based on all available clinical studies, pre-clinical reports and other scientific information, should utilizing testosterone replacement therapy represent a significant concern for this former PCa patient at this time?"

- A second AI research question should duplicate the first AI research question, but also include an extra sentence which states, "Please limit your consideration of clinical and scientific reports issued after 2014."

Why do this??? Because this is what I did for myself and I found the results to be eye opening:

- AI research question #1 was skeptical and highly reluctant to embrace TRT.

- AI research question #2 was significantly more positive, concluding it would be reasonably safe to resume TRT in my situation based on current scientific evidence. Plenty of supporting analysis, footnotes and source materials were included as part of the AI report too.

Gosh -- it was so impressive. I think the AI world is ushering us into the dawn of a new medical era. Patients are becoming empowered.

It's obviously your call on what to do and how to proceed. Nonetheless, you can count on me cheering for you.