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Ask The Urologist Anything (Dr Michael Rotman)
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<blockquote data-quote="Bookersnookers" data-source="post: 92091" data-attributes="member: 17355"><p>Hi Dr. Rotman</p><p></p><p>I am a 39-year-old male with no family history of prostate cancer. I have been on TRT for five years. I am on TRT because like a fool I abused steroids for a couple of years in my early 20's. I had no issues while on TRT outside of a high hematocrit and high estrogen when my test dose was too high. My current test dose was a 100mg sub c once a week. During this five year journey, I have learned that I needed to be proactive in learning about the right treatment as many Dr's have no idea on how to treat low t. I had a great Urologist in NYC but moved in April of 2017 and started with a new DR. </p><p></p><p>I continued my 100 mg once a week with this new dr, and he drew blood on my first appointment in April. I had a second meeting in June and drew blood again. My third was in September, and he finally decided to review my bloodwork and revealed my PSA was a 2.75 than a 2 and then a 2.53. The morning of each blood draw I had sex. I never knew sex impacted PSA. After abstaining from sex, my PSA was a 2.20. He wanted to rush me into biopsy, and I declined.</p><p></p><p></p><p>I went for a second opinion and another blood draw. That blood draw reflected my PSA was a 2.20. This Dr gave me a rectal exam and said my prostate is enlarged, but the prostate was smooth. He told me to come off TRT and come back in 7 weeks. I am at week 4 and feel terrible. He wants to draw blood and see if the testosterone is causing the high PSA numbers. I went through my old blood work and found one lab from 8/2015, and my PSA was 1.75. He said the jump from 1.75 to the high of a 2.75 is concerning. He didn't think it was crazy the first DR recommended biopsy but felt coming off the TRT was the next best approach.</p><p></p><p></p><p>My good friend is a Dr. He is not a urologist. He thinks since I am under a 2.5, a smooth prostate even though enlarged, and no family with prostate cancer a biopsy is being overly cautious. He told me to continue my TRT use something to treat BPH and continue to monitor my PSA level.</p><p></p><p></p><p>What would you do if you had a patient in my situation? SHould I wait for another four weeks before having my PSA checked or can I go now? I would hate to come off TRT permanently. Its really changed my life for the positive.</p><p></p><p>Are you the Dr. Rotman in Lawrence Long island?</p></blockquote><p></p>
[QUOTE="Bookersnookers, post: 92091, member: 17355"] Hi Dr. Rotman I am a 39-year-old male with no family history of prostate cancer. I have been on TRT for five years. I am on TRT because like a fool I abused steroids for a couple of years in my early 20's. I had no issues while on TRT outside of a high hematocrit and high estrogen when my test dose was too high. My current test dose was a 100mg sub c once a week. During this five year journey, I have learned that I needed to be proactive in learning about the right treatment as many Dr's have no idea on how to treat low t. I had a great Urologist in NYC but moved in April of 2017 and started with a new DR. I continued my 100 mg once a week with this new dr, and he drew blood on my first appointment in April. I had a second meeting in June and drew blood again. My third was in September, and he finally decided to review my bloodwork and revealed my PSA was a 2.75 than a 2 and then a 2.53. The morning of each blood draw I had sex. I never knew sex impacted PSA. After abstaining from sex, my PSA was a 2.20. He wanted to rush me into biopsy, and I declined. I went for a second opinion and another blood draw. That blood draw reflected my PSA was a 2.20. This Dr gave me a rectal exam and said my prostate is enlarged, but the prostate was smooth. He told me to come off TRT and come back in 7 weeks. I am at week 4 and feel terrible. He wants to draw blood and see if the testosterone is causing the high PSA numbers. I went through my old blood work and found one lab from 8/2015, and my PSA was 1.75. He said the jump from 1.75 to the high of a 2.75 is concerning. He didn't think it was crazy the first DR recommended biopsy but felt coming off the TRT was the next best approach. My good friend is a Dr. He is not a urologist. He thinks since I am under a 2.5, a smooth prostate even though enlarged, and no family with prostate cancer a biopsy is being overly cautious. He told me to continue my TRT use something to treat BPH and continue to monitor my PSA level. What would you do if you had a patient in my situation? SHould I wait for another four weeks before having my PSA checked or can I go now? I would hate to come off TRT permanently. Its really changed my life for the positive. Are you the Dr. Rotman in Lawrence Long island? [/QUOTE]
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