Testosterone replacement yea

Wow I was really not expecting this outcome but...New urologist who specializes in hormones and impotence is fine with prescriptions of testosterone cyprionate and sent for a ten cc vial at 200mg each week, it's good for ten weeks if I'm doing the math one CC equals 200mg
Actually he wants me to be at 350mg every two weeks or 175mg weekly
My gung ho clinic had me on 650mg every two weeks but due to my inability to walk a lot, gave me the next dose in two syringes of 350 each to save me a visit however I cheated and in two weeks took one shot and after another two weeks I'd take the second.
So Dr Akulai said that I ought to stay at the 350mg per two weeks. He saw my estradiol was very high and prescribed Astro- something of which I forgot the spelling of.
He said more is not always better and I believe him. My current level of T is 1,280 and I feel the same as when it was in the 700,s
Anyway I'm over the moon! Not only do I no longer have to take two subway rides, the Staten Island ferry and a bus but each dose was $106 making $216 plus each month.
Dr is $45 copay and I remember testosterone cyprionate is reasonable copay.
Plus my oncologist and urologist are all in my treatment loop here at Columbia Presbyterian hospital. Actually my radiologist I'm not sure if oncologist is also his title Dr Deutsch is his name
Yea for me
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
Oh I'd add that I no longer need to lie about my PCA treatment.
My last PSA is 0.49 before treatment it was as high as 7.4
Actually I never lied to my oncology team I just omitted my having PCA when I went to the clinic
G
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
I have friends who have ramped up T after successful treatment! They seem really happy! It is not for everyone! Some people could experience serious recurrence. I may be about to put this concept to the test. My oncologist and I are discussing tea replacement therapy and we will make a decision at my next Oncology visit which currently is six months out. For those who don’t know me a little history.! (I still have a prostate, I was diagnosed stage four, my original PSA was 3200! With very few exceptions, I have been on hormone therapy of one form or another for 20 years. In June 2024 I received my last Elgard injection and stopped taking Zytiga a month later. Fast forward, 19 months down the road or thereabouts, and my PSA level remains undetectable. Sadly, my testosterone level has remained undetectable. The odds are my team will say sorry Todd not for you. I guess I’m OK with that. However what if the cancer has been cured?. I’m torn between two Bible verses. One has to do with the mustard seed and the other has to do with putting God to a foolish test. Which one would you decide lol.
DX 2006 age 42 PSA 3216 stage 4 Gleason (3+4=7 ) Lung, Bone, Lymph Metastasis. Unconfirmed Brain Metastasis. Original prognosis < one year.
Currently 55 years young. Treatments included ADT Lupron and Casodex, DES, Provenge, Zytiga. Last scans clean. Last PSA <0.01 On a treatment holiday.
Todd's blog
Twitter @seals_todd
Todd it's a hard choice. I really had little choice as I suffered so badly with low T
Actually my clinic already ramped me up to 650mg
Now I have to take half but I don't worry about it. I take it for emotional effects not body building.
Wish you the best

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021

theswan said...
Oh I'd add that I no longer need to lie about my PCA treatment.
My last PSA is 0.49 before treatment it was as high as 7.4
Actually I never lied to my oncology team I just omitted my having PCA when I went to the clinic
G



Nice to read about a happy swan!
Thank you Sailor
I just took home my $45 bottle of ten CC's of testosterone-Each CC equals two hundred mg so I have enough for a while.

He forgot the needles and syringes but I have a few left over from years ago-they do not go "bad" I will call the office.

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021

theswan said...
Wow I was really not expecting this outcome but...New urologist who specializes in hormones and impotence is fine with prescriptions of testosterone cyprionate and sent for a ten cc vial at 200mg each week, it's good for ten weeks if I'm doing the math one CC equals 200mg
Actually he wants me to be at 350mg every two weeks or 175mg weekly
My gung ho clinic had me on 650mg every two weeks but due to my inability to walk a lot, gave me the next dose in two syringes of 350 each to save me a visit however I cheated and in two weeks took one shot and after another two weeks I'd take the second.
So Dr Akulai said that I ought to stay at the 350mg per two weeks. He saw my estradiol was very high and prescribed Astro- something of which I forgot the spelling of.
He said more is not always better and I believe him. My current level of T is 1,280 and I feel the same as when it was in the 700,s
Anyway I'm over the moon! Not only do I no longer have to take two subway rides, the Staten Island ferry and a bus but each dose was $106 making $216 plus each month.
Dr is $45 copay and I remember testosterone cyprionate is reasonable copay.
Plus my oncologist and urologist are all in my treatment loop here at Columbia Presbyterian hospital. Actually my radiologist I'm not sure if oncologist is also his title Dr Deutsch is his name
Yea for me



I basically was castrate and recently started TRT through my PCP after approval of Cleveland Clinic. Normal T levels are considered 300-1000 and T cypionate has an 8 day 1/2 life. My dose is 100MG each 14 days. Day 13 T is about 280, day 6 is about 680..


I am on traditional Medicare with a medigap G and $7 a month D plan. So I have $280 out of pocket in 2026 for all my provider and lab visits. My drug cost is $5 for 200mg (1 month) and about $10 for a 90 day supply of syringes and needles on my budget Medicare D plan. This means all my costs for 2026 for T replacements are capped at $380.

$216 a month (>$1,300 a year) sounds expensive and your dosing likely has your T levels through the roof at times.

Post Edited (Duck2) : 1/23/2026 10:17:03 PM (GMT-5)

It was excessive as was the dose but the clinic is crazy about T and claim so many benefits and I kinda bought into it.
Partly it was "more has to be better than less right?" In any case my goal was always to get back to sensible regimen with a doctor aware of my situation.
Just checked the Aetna website PPO and the cost of the 10cc was $20.73 I have a few syringes left from years ago but will need more plus they are a larger bore and it is gonna hurt a bit.

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
If you can, you may want to get 2 size needles if the larger diameter bother you. Cypionate is thick and drawing into a smaller needle a bit of a pain. Use a large needle to load and a small needle to deliver. Also the needle not puncturing the vial will remain sharp.
Yes I recall using a 19g to withdraw and switching out the needle to a 22g or 23G odd but the larger number is actually smaller bore. Old MD was wasteful because we only need one barrel, plunger and needle then a second set of only the smaller needle so we just twist off the 19g for a 22g

G
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
I go in every four months and have 12 Testopel pellets inserted in my hip. My body stopped producing T after HDT and I hated how I felt with low T. It is a godsend and the pellets metabolize over the four months and provide me with much needed TRT.
I am a Gleason 9 Stage 4 survivor and refuse to live without Testosterone. It sounds like injections are a common TRT procedure. But I love the pellets.
I'm happy for you for taking charge of your life. It is clear that you understand how low T makes you feel.
I've heard of the pellets and glad they work. I like injections but I also tried Androgel which works great but it's a messy every day thing that gets old fast.
Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
DAMN! I am SO GLAD I stumbled upon this thread. I posted my update today, but it sounds very much like Todd's above. No surgery. Proton radiation 44 treatments. Oncologist was not gung ho about me resuming TRT, but conceded that it is a quality of life issue. But PSA is gradually rising.

My endocrinologist, who specializes in TRT said the old thinking that "testosterone is like throwing gasoline on the fire" is totally BS. He is not letting me run the test levels that I used to before PCa when seeing a geriatric specialist who since retired. I am prescribed TWO SQUIRTS of AndroGel. (I usually have sufficient to cheat and take THREE). I drop back to the prescribed two squirts before getting tested and I am running around 400. (That 1200 level is a bit crazy high, isn't it?)

Anyway, SWAN glad to hear you've found the right doc/clinic!
Dx 12/29/21 @ 66yo PSA 4.7 (w/FINASTERIDEt real PSA is 9.4
11/15/21 Fusion MRI & Biopsy - G8 (4+4, 75%,50%,50%) Highest Grade Group 4
9 of 16 Ca/ PNI/ PSMA PET Scan--No evidence of mets, but one pelvic LN was hot. Jhopkins 2nd opinion: upgraded to G9.
Opted for Proton RT & ADT (Eligard 24mo. Zytiga added June '22 - discont Mar '23 with stroke. Quit the Eligard after 18 mo. 1st PSA undetect
Good for you
My clinic was my only choice because I couldn't find any doctor that was going to prescribe testosterone with my PCA.
It's only now with my low PSA and years away from sbrt that I was able to use the same place I was treated for the PCA
The guy who ran the clinic although actually a surgeon wrote books on testosterone and T is basically his pet and yeah he likes high numbers.
Since I was not disclosing my PCA I didn't want to argue nor rock the boat.
Eventually I found my guy and I'm good with 350mg two weeks.
Anyway I am happy for you.
I'm having second hip surgery next week and scares me as usual. One worry is the pain is mostly in the area of sciatica and only some in the groin. Last hip issue was mostly in the groin.
Hate to wake up with same awful pain.

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
Since we're discussing prices I spend about $70 a month for a compounded gel that I apply daily. That comes to a bit more than $800 per annum - not free but not crushingly expensive and it keeps me where I need to be.
-
The way I think about T supplementation for men who have been treated for prostate cancer is that the decision to supplement is pretty much the same decision as terminating ADT. When you stop androgen deprivation you do it in the expectation that testosterone will return to more or less normal levels. When you supplement you are also looking to get back to normal levels. Both have some risk of recurrence but it's pretty much the same risk.
68 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional
Hello Peter

My T levels might rise a bit but not too much. I have been using buprenorphine for pain since 2008 off and on. Started in a clinical trial for pain patients who were having a hard time staying on same dosage. I have a extreme tolerance and needed more and more until I was on a crazy high dose (90mg morphine three times a day plus percocet for breakthrough pain,
So in hospital, the weaned me very quickly (hours) and introduced the buperenorphine until I felt "normal" then they tweaked the dose to find what killed my pain and kept withdrawals away (16mg then)
I went off for a year but pain was too much so I slowly went back to it and dose went up.
Basically the opioid med destroys my body's ability to make enough T
So I will require TRT for life.
The "bupe" is a decent pain killer but not a great one so the few surgeries I have had have been a little tough as far as managing the pain but I add tylenol and a NSAID like ibuprofen and I get by
Hip replacementis due Tuesday so I already spoke to the doctors about how best to deal with post op pain.
(each surgery this past few years they issist on trying fentylal but I say do not waste the effort-bupe clings to the receptors like super-glue)

Wow off topic a bit but its been on my mind as of late

G
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
Oh happy days...Oh happy days...sung with the same tune as is Sister act2...
logo -- If this board had emoji's or smilies, I would give you the biggest smile for this last comment!

Of course, being "old" I prefer the song as recorded by the Edwin Hawkins Singers in 1968 or 1969, but the joy is still real.

Guys -- I am really happy for all who are posting on this thread. If you look back 8 or 10 years, you will see my old posts indicating that I have been able to continue TRT before, during and after my SBRT in 2016.

I don't want to get all "preachy" about it, but as Dr. Morgentaler said, my body cannot discern between the T it might make itself (or might not) and that which I purchased at the pharmacy.

I am still using a generic topical gel which, with my insurance, costs me all of $30 for a 3-month supply. Yeah, it is a bit slimy to apply, but I've been using it for over 13 years and it works just fine for me.

Carry on.
Age 68 at Dx
PSA history: 2000-2012 0.9-1.2; 06/2012 started T replacement
2013-2015 3.0-3.3 (new normal); 11/2015 4.6; 05/2016 5.7
Biopsy: 12-core biopsy 07/2016; 3 cores G3+3, 5% or less; 1 core 3+4, 15%; 2% involved. Summary G3+4. SBRT 11/16. PSA 10/20=0.96;06/22=0.47; 02/23=0.26; 08/23-0.24; 11/24 0.12; 01/26 0.08
Ten days since new hip replacement.
Pain control was very tough but I think I turned the corner.
Again I'm off topic but I have had it rough lately. DR said no testosterone until the 25th because it can effect the implant. I read up on this and I think I'll obey and wait.
Side note and sorta gross but I'll share it.
Constipated for eight days and I finally found a seat combined with a cushion that hovered over the toilet and with a lot of laxative suppositorys and a oil fleet enema I had a movement!
Sitting on the hip replacement scar well, OOUCH!! Don't wanna go through that again!
Too much information? Yeah sorry about that but oh what a relief 😮‍💨

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
Side issue.
Had hip surgery and almost three weeks ago and I still hurting.
Weird but not on hip but knee and lower leg.
Buprenorphine no longer working sad to say
Sorry it's off topic but almost three am and I'm up in pain.
Time and PT should be the cure. Right now?
Auugh it's hurting like heck

Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021