I doubt it is more harmful the chemo though. lol there aren’t too many options out there for cancer treatment that don’t involve some serious side effects.
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I think citrate is something that could be particularly helpful here and is otherwise not harmful (although you can have a laxative effect).
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Good old Vitamin C to the rescue:
Cancer patient survival doubled by adding this common vitamin to chemo: study | Fox News
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What information do we have on prostate enlargement/prostate cancer and TRT? I’ve got a guy who is interested in starting TRT but is hesitant to start because his doctor scared him about prostate cancer, but his PSA is 1.5 at age 70. I’ve seen studies showing it doesn’t increase cancer risk above the “saturation” point.
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This is a deep dive that includes evidence that TRT can reduce the incidence of PC and that, with many forms of PC, the outcome is better if the patient is also on TRT. The best source I am aware of is Attia’s Podcast #310 with ed Schaeffer, M.D., Ph.D… This is a brief summary.
Summary: Testosterone, TRT, and Prostate Cancer — Schaeffer/Attia Discussion
The TRAVERSE Trial The trial enrolled ~5,200 hypogonadal men and found no statistically significant increase in prostate cancer incidence with TRT (12 vs. 11 cases in treatment vs. placebo). The testosterone bump was modest (~140 ng/dL), follow-up was only 33 months, and dropout exceeded 60% — so power to detect a prostate cancer signal was genuinely limited. PSA tracking remained useful: the men who did develop cancer had higher baseline and rising PSAs, consistent with standard screening logic.
Androgen Receptor Saturation Theory This is arguably the mechanistic centerpiece of the discussion. The prostate (like hair follicles) likely reaches AR saturation at serum testosterone levels around 200–250 ng/dL — well below the population median. The amplification mechanism is local 5α-reductase converting T→DHT (~10× potency). Practically, this means the vast majority of men are already operating on the saturated portion of the dose-response curve, so incremental TRT to eugonadal levels adds little additional androgenic drive to prostatic tissue. Muscle, by contrast, saturates at much higher levels, which explains why anabolic effects from TRT are real while prostatic stimulation is minimal.
AR Activity and Cancer Aggressiveness — A Counterintuitive Relationship Schaeffer’s own work identified a 9-gene AR activity (AR-A) signature, showing that more aggressive tumors paradoxically display lower AR activity. High-grade cancers have decoupled from canonical androgen signaling and instead amplify alternative pathways (PTEN loss, Myc, etc.). The clinical implication is significant: a high-T environment actually tends to favor differentiated, less aggressive tumor biology, while low-T environments may select for AR-independent, harder-to-treat phenotypes. The garden analogy — AR-high tumors as large weeds with shallow roots vs. AR-low tumors as deeply invasive — is apt.
The Decipher Score in Clinical Practice The CLIA-approved Decipher assay (VeraCyte) uses ~20-22 gene mRNA expression from biopsy or resection tissue to score aggressiveness. The broader “GRID” includes the AR-A signature and can classify tumors as basal vs. luminal. For low-grade (Gleason 3+3) cancers, the AR-A score rarely changes management (~7% are molecular outliers). For higher-grade disease, it becomes more consequential — particularly in choosing between surgery (which preserves the option of continuing TRT) versus radiation (which typically requires ADT, with significant morbidity and incomplete T recovery in 40–50% of men even after 2 years).
Clinical Counseling on TRT Schaeffer’s position is notably more permissive than the conventional urological stance:
- For symptomatic hypogonadal men without cancer, he sees essentially no contraindication to TRT
- For men on TRT who are incidentally found to have Gleason 3+3 on biopsy, he does not discontinue TRT — citing no evidence that exogenous T accelerates low-grade disease
- For higher-grade cancers requiring treatment, the surgery vs. radiation choice is significantly shaped by TRT considerations: surgery allows TRT continuation post-treatment; radiation typically does not, due to ADT requirements and residual PSA signal from benign tissue confounding recurrence detection
PSA as a Precision Tool A key contrast drawn with breast cancer: PSA allows detection of recurrence at the level of ~100–200 cells, enabling targeted salvage therapy rather than prophylactic adjuvant androgen suppression across the board. This is the prostate cancer field’s major advantage over ER+ breast cancer management, where 5 years of adjuvant anti-estrogen therapy is standard despite significant morbidity. Ongoing NRG trials (GU009/010/011) are actively testing AR-A-guided intensification/de-intensification of ADT in radiation-treated higher-grade cancers — results expected within ~2 years.
Bottom Line The evidence increasingly supports that TRT to eugonadal levels does not meaningfully drive prostate cancer initiation or progression in low-grade disease, and the mechanistic rationale (AR saturation, AR-A tumor biology) is solid. The most clinically actionable takeaway is that treatment modality selection for intermediate/high-grade disease should explicitly factor in testosterone preservation — with surgery offering a meaningful advantage for patients in whom maintaining eugonadal status is a priority.
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Well, here is my n=1. Was diagnosed with PC in 2014. Never been treated though took metformin, then rapamycin and now SGLT2 drug - no progression and I have been taking TRT for 5 years. This whole T is causing PS is bullshit science
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GP has scared tf out of this guy. The annoying thing is GPs are completely uninformed on hormonal health, HRT and their connection to prostate health. It’s just not their expertise and they hold on to outdated dogma.
This guy has fairly good blood markers other than testosterone, and has symptoms I know will be addressed by TRT (fatigue, a little anxiety, not a lot of gym progress, low motivation/drive and waning libido)
The irony is he has been very interested in TRT for a long time and his GP has just been giving him a blood test periodically and saying “come back in 6 months” but the moment he said to the doctor that he was going to go to a private clinic to be treated the doctor put the scare tactics on him. Such a scumbag move.
He showed me a single study cautioning men from using TRT in general as a preventative for prostate health.
I sent him a large amount of evidence to go through and said get back to me in a week after he calmed down and thought logically about the situation.
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