video from PCRI suggests long-term beam radiation BCR rates are 50%

Posted by ozelli @ozelli, 6 days ago

Here is a link to:


Bit shocked/surprised by this to be honest. am I misinterpreting this?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for scottbeammeup @scottbeammeup

@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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@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!

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I was an avid follower of these videos, but I noticed contradictions in different videos. This one seems to lack a great deal of context. Having had SBRT, it concerned me, so I looked at the abstract.

But this bothered me-

Patient group < 600
Treated between 2004–2007.
Definitive EBRT” with a median dose of ~75.6 Gy. This would not include SBRT as it was considered experimental at the time.
Delivered in conventional fractionation (about 1.8–2 Gy per fraction).

What I can't understand is how he promotes the great superiority of modern radiation and then hangs his hat on a study on patients treated with 20 year old technology.

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That's why I hate videos like this. I won't watch them. UG also suggests staying away from them. If you want to be miserable watch it and let it run wild in your mind. If you have been treated and numbers look good go live your best life. If you haven't been treated try to live your best life until treated. If you are in the middle of treatment and the struggle is real, live your best life the best you can. Surround yourself with positive supported empathetic people. This video is so old it is no longer relevant. I personally would like to see it removed due to scaring the bejesus out of research novices. Want to look at something? Checkout the Stampede study and NCCR treatment protocols which have up to date information. Just my thoughts on this. This post is my personal story while waiting. Best wishes on your journey.

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Profile picture for heavyphil @heavyphil

@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!

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@heavyphil Thanks for the feedback. It's appreciated. I also appreciate hearing that early 60s is "young." 😃 My PSA of .04 after a year (still have a prostate) makes me feel more comfortable with at least trying T supplementation. I thought maybe my low T is what was keeping my PSA as low as it is but my oncologist said once it's above ~50 that's not the case.

You're right--it does come down to a choice of taking Reclast, Crestor and maybe a diabetes drug or trying T supplementation. My oncologist did make it clear that they're not going to turn me into superman, and that for the first year I will be back to more frequent monitoring vs. the six month schedule I'm on now. That does seem to indicate the doctor is being cautious.

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Profile picture for scottbeammeup @scottbeammeup

@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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@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.

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Profile picture for kenk1962 @kenk1962

@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.

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@kenk1962 This was really helpful. The data showed LESS mortality in those treated with TRT post PC with low PSA than those who were not. "The best modern evidence does not show higher recurrence rates in men on TRT. In fact, some series tilt toward better outcomes. That doesn’t mean it’s a free pass—you still need PSA checks—but the fear of “pouring gas on the fire” is not supported by the data."

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Profile picture for scottbeammeup @scottbeammeup

@kenk1962 This was really helpful. The data showed LESS mortality in those treated with TRT post PC with low PSA than those who were not. "The best modern evidence does not show higher recurrence rates in men on TRT. In fact, some series tilt toward better outcomes. That doesn’t mean it’s a free pass—you still need PSA checks—but the fear of “pouring gas on the fire” is not supported by the data."

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@scottbeammeup Yes - precisely. It's great news that many in the urology profession do not seem to be aware of.

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Please could you let me know what TRT means. Thanks 👍

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Testosterone Replacement Therapy

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