As you know, my only concern has ever been how to read PSA with TRT after radiation. For favorable risk PC, I think the way you did it was the right way:
1- start TRT before
RT to get a more useful PSA baseline
2- supplement only to normal levels
3- do not over-react to PSA bounces
But the editorial rightly points out that for unfavorable risk, the association with testosterone does not conform to the saturation hypothesis. The association is u-shaped: both very low and
high chronic T levels are associated with high-risk PC. This was not true for low and intermediate risk PC.clincancerres.aacrjournals.org/content/18/13/3648.long
It is not surprising that T is both an agonist and an antagonist at least for some kinds of PC. We know that estrogen is both. It may be that saturation explains some but not all of T's effect on PC. I'm intrigued by the Restrelli's curve too. I wish I had the actual data, so I could take a stab at an alternative curve-fitting scheme. Perhaps I will write to Restrelli and propose it.
I very rarely hear objections from Uros or ROs to TRT after evidence of successful PC treatment. I did have to school my PCP, but he responded well to evidence.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEsmy PC blog