Anyone have testosterone replacement therapy (TRT) after ADT?

@odie10 Depending on how long you were on Eligard, it will be many months before testosterone levels return and side-effects (fatigue) wear off. Note that fatigue can be a side-effect of Nubeqa (darolutamide) as well. (See attached chart.) Watch for that.

(I forget whether you mentioned if you’ve had those bone lesions treated yet?)

@ava11
I am 73. G9 treated with RP, triple therapy and pelvic radiation. Oligometastatic disease with solitary T8 bone met successfully treated with SBRT. Off Lupron after one year with undetectable PSA. One year after discontinuation of Lupron my T never got above 40. My MP put me on TRT. Energy levels back to pre cancer. Libido back. Hot flashes gone. Body hair grew back. No unwanted side effects.

@retireddoc

My urologist will not even consider TRT for me because it is not standard practice. If these doctors would just keep up with the latest research data, they would learn that high testosterone is the best defence against aggressive prostate cancer. They would also learn that ADT can cause major heart, bone, and muscle damage that can be life threatening. I had horrible side effects and after a year have recovered only to a testosterone level of about 115 which still leaves me with painful side effects. I will have to find another urologist.

Hmmm, I've posted a few things based solely on my experiences and my Oncologist:
67, metastatic now castration-resistant prostate cancer.
I say triple-check everything. I was advised that T feeds the cancer, so it is inadvisable to boost T with androgen-dependent cancer. Even when castration-resistant...there may be a few T cells 'hanging around' that would want to contribute to the cancer. Remember that Prostate cancer can be extremely aggressive and finds alternate pathways to spread....
I have chosen to deal, for now, with the fatigue, hot flashes, lack of libido, energy, etc. and brain fog associated with the ADT, knowing that potentially the cancer can 'take it and run' with the T. However, there is a report that indicates that long-term severe suppression (ADT) can force the cancer to be Androgen independent (castration-resistant)....Perhaps that is my dilemma...??!! My T remains <20...but PSA rises...on Pluvicto now.
Therefore, it remains a 'crap shoot'...damned if do and damned if don't. Just continue to monitor PSA, take a scan when necessary, etc...
Blessings

@pesquallie
Ahh yes...many things to consider. I have been on ADT for a number of years and realize the hardship on the body...thereforeI, I've ceased Eligard (when I was on it) and Firmagon (which I do every 6 weeks, rather than every 4). My body loves the break!...I return almost to normal!
I've never read that keeping a high T level is a defense for PCa in any form, although while cutting off testosterone treats prostate cancer, new research shows that "bipolar androgen therapy" (BAT)—a treatment that involves rapidly shifting between high and low levels—can re-sensitize resistant cancer cells to treatment....
...I find PCa extremely interesting...I just wish I wasn't dealing with it...you know??

@deccakid
Correction...when I say 'cease' I mean I take a 2-3 month break...to return to the ADT after that time...

@retireddoc
You are a young man and you have no prostate. I still have my prostate and a lot older! My oncologist is open for me to undergo TRT. But I am just afraid that cancer may come back.

@pesquallie
While testosterone can be real beneficial against aggressive prostate cancer. People have both aggressive and non-aggressive prostate cancer in their bodies. The testosterone can reactivate the non-aggressive prostate cancer. That’s why it doesn’t work for some people.

I was ready to start TRT, and my sexual health doctor agreed, when my T was still low a year after finishing six months of ADT. My oncologist recommended against it.

I went to see a urological oncologist for another opinion. My T was ~250 at the time a full year after stopping ADT. I'm a data analyst so live my life based on numbers but, objectively, I felt fine at 250--could work out, good libido, working man parts, decent mood, no anemia, etc.

I went to see a urological oncologist who said he's treated prostate cancer patients with TRT and has seen no more recurrences than in those not treated.

He said I could start TRT but asked "what is the problem you're trying to solve?" He told me T is not the miracle drug people make it out to be and gently suggested that perhaps I'm spending too much mental energy on a number vs. symptoms. He suggested that, since I was feeling OK, I should wait 18-24 months and that TRT was always an option if my testosterone plummeted in the meantime.

Sure enough, at my last test, my T FINALLY jumped to 430, well within the normal range. And as a bonus my PSA is still undetectable and I've been moved to six month monitoring.

I'd base your decision on 1. is your T increasing on its own, even slowly? and 2. are you having bad symptoms?

Different than most replies: age 70, have no history of prostate cancer (probably enlarged, but dealing with it), PSA steady at about 0.5 for years. Low testosterone so primary physician suggested Testosterone shots. Totally whacked me out! Wanted to screw anything and everything like I was 18 (wife wanted no part of it, though). Moody, depressed with self harm thoughts. Aggravated that I was sexual but had no outlet. Thoughts of divorce to eliminate mood. It was awful! 4 weeks into it, told Doc, he said I should have stopped IMMEDIATELY (but I did not know if I needed to ease off or just stop-so waited to see him). It was truly a nightmare (and YES, my wife noticed it ALL!)