@heavyphil I am on active surveillance with TRT, Gleason 6. Originally my urologist took me off TRT was pushing for prostatectomy, but Moffit Cancer Center put me back on TRT and has me on active surveillance. Blood test every 6 months, MRI every 12, and biopsy every 18 months.

Food for thought: There is a ton of emerging data that suggests that there is NOT a linear connection between testosterone and prostate connection.

There was a bipolar androgen study that showed small doses of testosterone increased cancer growth, while high doses (beyond saturation levels) actually stopped the cancer growth in later stage prostate cancer.

Another study out of the UK showed that there was NO statistical difference in outcome between those who were put on active surveillance, those who had radiation, and those who had a prostatectomy over 5, 10, and 15 year periods.

Several META and population studies showed that the patients they monitored over a multi year period who were on TRT and active surveillance showed no increase in PC growth. My Urologist has patients on TRT and active surveillance for several years with the same results.

Although the emerging data is not conclusive, it demonstrates that the prevailing theory that "using testosterone is like putting gasoline on a fire" is not accurate and that there is NOT necessarily a linear connection between the two.

These studies I found were enough to question three urologists who I consulted with who all admitted that "they really just do not know" and that there is much they have to learn about the interaction of testosterone and prostate cancer. One was the surgeon who was to perform the prostatectomy had I agreed to go forward with the procedure.

Disclaimer: I am not a doctor and you should always follow your doctor's instructions.

@heavypilheavyphil the Mayo Clinic checks my PSA twice a year and I will be having a 3T mp MRI later this month. My two previous MRI's did not show any lesions, Pirads 2. My PSA is usually below 2. The whole thinking on testosterone has evolved alot in the last 5 years. Having a Gleason 6 like me stop TRT would be like have all men first diagnosed with Gleason 6 cancer immediately go on ADT. That just does not happen. I am 71 years old and play golf 3 times a week so I'm in fairly good shape. I've learned to just live with this cancer. When I was first diagnosed I certainly felt that I needed to do some treatment. But as you read the experiences of men on just about all of the treatments you find they mostly all have some negative issues. Its a tough deal. I study and research everything I can on prostate cancer knowing some day it may/will be time to treat it. The Mayo will probably do a biopsy again if something shows up on the MRI. From what I have read, prostate cancer is the only cancer where biopsy is done without an MRI in some instances. All other cancers they do an MRI first and only biopsy if something shows up. They never just start poking needles into the brain or some other area of cancer if there is nothing on the MRI.