Recent content by tcmi

As someone who has had prostate cancer, having had a radical prostatectomy at age 51, I'm troubled - bordering on irritated - by the narrative of these underlying stories focused on PSA. The problem with unnecessary biopsies is not the PSA test, it's more likely the physician using the PSA...

I had to apply twice per day (morning and evening) to feel good which is not that uncommon. It’s also the main reason I went back to injections as I found it much simpler to inject every other day with an insulin needle rather than apply the cream twice every day. I tried cream two separate...

While not often acknowledged, differences (if any) between IM and SubQ can also be related to your body fat. I’m at about 12% (with very little fat) and can easily inject into muscle with a 1/2” insulin needle.

I had 3+4 as well. Chose robotic prostatectomy at Memorial Sloan Kettering in NYC. Excellent surgeon, excellent outcome. My surgeon allowed me to remain on TRT until week before surgery. I was allowed to resume TRT 6 weeks post surgery after an undetectable PSA test. I remain cancer free...

Yes. I had been on 5mg daily and switched to 2.5mg. 20mg daily does seem unnecessarily insane.

I think it was relatively indifferent. My surgeon was well informed on TRT and had no issues with resuming as long as surgery went as expected (it did). A small part of my decision to have surgery vs other treatment options was a desire to restart TRT as soon as possible. When you have RP...

I was on TRT until two days prior to my surgery. I resumed TRT six weeks after surgery (following a great pathology report and undetectable PSA).

Good article overall, and active surveillance can make sense in many men. But be careful about the details of their “argument,” that mortality in the “treatment group” was no better than the “surveillance,” group, while acknowledging that the cancer in the surveillance group is more likely to...

I had similar path, with RP done at 51. My PSA was only 2.6 yet the tumor was sized at about 20% of the prostate gland, and immediately adjacent to one of the two nerve bundles. A decision to watch and wait at 70 is a lot different than if you’re 50.

your high free T indicates low SHBG; you can very likely lower your T dosage and still be at the high end of Free T range. If you’re concerned about low iron, stop donating blood. You can likely bring down hematocrit by lower T dose. Stop taking AI and let your E2 settle naturally - it will...

So the challenge is determining the “physiological ranges” for estradiol in a healthy older male, at a healthy weight, with healthy testosterone levels.

Anyone else have heartburn issues with daily Cialis? I had to stop for that reason.

In most cases, the thing making the most difference is frequency of injections rather than “subq” vs “IM” as most people doing IM are injecting 1-2 times per week, while most people doing “subq” are doing every 1-2 days. Part of it is simply a practical matter if needle gauge. Most people...

Sorry to hear your story. Been there, done that. Awful experience - I've never felt worse in my life. I was also told to take 2mg Arimidex. It completely killed my estradiol. I had no idea what was going on. The doctor didn't know what he was doing. Like you, I finally just stopped cold...

For whatever it's worth, I was on TRT for 5+ years, was diagnosed with PCa in 2021 (Gleason 7 3+4). I had RP surgery in August 2022 at Memorial Sloan Kettering in NYC. I was asked to stop TRT the week prior to surgery. I was then able to resume TRT after surgery given a clean biopsy report...