TRT and Prostate Cancer: Safety and Eligibility

It's natural to wonder if testosterone replacement therapy (TRT) is safe after prostate cancer treatment. Many men in Florida face this same decision each year.

Although you've read in online forums that "testosterone feeds prostate cancer," recent research offers a more nuanced understanding.

Studies now show that for some men, especially those carefully monitored after prostate cancer, TRT can be a consideration. The key factors include your cancer status, PSA (prostate-specific antigen) trends, and timing of therapy.

Is TRT Safe After Prostate Cancer Treatment?

It's essential to understand that physiologic TRT (therapy aimed at normal testosterone levels) hasn't been shown to trigger new prostate cancers in men without prior cancer. 

However, if you've already been treated for prostate cancer, decisions around TRT depend heavily on your unique medical history, current PSA, and cancer-risk profile.

TRT restores low testosterone (hypogonadism) to normal levels to help improve symptoms like low energy, reduced libido, and muscle loss. It’s given through gels, injections, or patches, depending on your lifestyle and preferences.

Monitoring PSA, a blood test that can indicate cancer recurrence, is crucial when considering TRT after prostate cancer treatment.

After prostate surgery, PSA typically drops near zero. Following radiation therapy, PSA levels reach a low point called the nadir and may fluctuate slightly (a "PSA bounce") without indicating recurrence.

Treatment Options at ACTC

At ACTC, your options after prostate cancer include observation, medications other than testosterone, lifestyle support, and, in select cases, carefully administered TRT.

Our approach is always personalized, based on your cancer stage, PSA levels, and symptom severity.

We consider TRT when:

• Your prostate cancer was low-risk or favorable intermediate-risk.
• You've had surgery or radiation with stable, low PSA levels.
• Symptoms significantly affect your quality of life.

We avoid TRT if:

• Cancer is active, metastatic, or resistant to treatments aimed at lowering testosterone (castration-resistant).
• Your PSA levels are rising or unstable.
• Your initial cancer had high-risk features, such as a high Gleason score or spread outside the prostate.

Our care includes close coordination between top-center-trained oncologists and your urologist. Together, we establish monitoring guidelines, including regular PSA checks and blood thickness (hematocrit) measurements.

Clear guidelines determine when therapy should be paused, such as if PSA indicates a possible recurrence or if your blood becomes too thick.

Support and Navigation

At ACTC, support goes beyond treatment decisions. Our nurse navigators coordinate your care by collecting medical records from outside providers, scheduling necessary tests, and tracking your results to keep everything streamlined.

We offer tele-oncology follow-ups when appropriate, allowing you to discuss test results and any symptoms conveniently without the need for frequent travel.

Throughout your care, our teams aim to provide a sense of comfort and reassurance. We care for every patient the way we care for our own loved ones.

Who We Treat

Our services focus primarily on adult and older-adult men, who often have multiple health considerations beyond prostate cancer—like heart health and bone strength—that influence TRT decisions.

If needed, we partner closely with your cardiologist or primary care physician to tailor a treatment plan that aligns with your broader health picture. We also encourage caregivers or family members to participate in consultations for comprehensive support.

Together, we’ll explore your TRT options, openly discuss potential risks and benefits, and decide on a monitoring strategy that suits your health and lifestyle.

Call 352-345-4565 or book an appointment.