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Testicular Cancer Survivor Needs Advice with TRT

Hello all,

New member as of today. I’ve been reading many posts on here over the last week and thought I’d give it a shot and ask for some feedback. Thanks in advance for any suggestions.

I’m 34 yrs old and only have my right testicle. I had testicular cancer (TC) on the left and had it removed in 2016. It came back in my abdominal lymph nodes in 2017 and I went through 4 tough cycles of chemo. So far, I’ve been all clear since, other than a small nodule on my lung that they are monitoring. It was great that the chemo killed the cancer, but it also kills the cells inside the testicle. Typically testosterone and fertility take a hit but usually rebound 1 year after chemo ends. I ended chemo in March 2018.

In May last year I ended up with gyno. I was told it happened because my T to E ratio was off from the chemo/surgery. I was put on anastrozole .25mg EOD to get rid of the gyno, but after several days I felt like death and stopped it. The breast tenderness eventually faded away, but the tissue is still there. Fast forward to today, and the past year has been rough. My libido is very low (I can get erections with manual stimulation only, even then they aren’t like they used to be), my energy is gone, I’m always tired and often feel depressed. I used to workout a ton and play sports, and now whenever I muster up the energy to lift lightweight, I’m sore for 8 days! I didn’t want to do HRT if possible, but at this point (even with normal values) I feel like something needs to be done. I honestly feel that my symptoms are T related. Here is a history of my endocrine labs and my most recent CBC, CMP:

Here’s where my problem lies. My Endocrinologist is suggesting a trial of TC, HCG, and AI (if needed at some point). I would be perfectly fine with that if it weren’t for the fact that HCG blood tests are used as a tumor marker to detect testicular cancer in the body (when HCG is elevated on the blood test, it means the cancer is back). There are 2 other markers (AFP, LDH), and I get all 3 drawn every 3 months. But essentially, taking HCG injections will make that test no longer useful for my medical team. My oncologist has no info on whether or not HCG can cause existing testicular cancer to grow more, and my endo has never treated a TC survivor…!

I’m a little stuck on my options and was hoping some of you have experience with this or have some insight to share. Please let me know what you think. If there is a way to get around using HCG while still keeping the testicle from atrophying, I’d love to hear it. I’d be ok taking HCG if I had some reassurance it wouldn’t aggravate cancer (the other 2 tumor markers would be sufficient for my medical team). Not sure if clomid can possibly help?? I’m a nurse by profession and have a good understanding of the basics and would love some feedback.

I really appreciate it!!!

Michael

It looks to me like your thyroid may not be producing well as indicated by your tsh being elevated. You should get a full panel run including T3 and Rev T3.

I would be nervous as hell with TRT with cancer cells present. Although it has been pretty much discounted that TRT can cause cancer, my understanding is that exogenous Test can accelerate existing cancer… I could be wrong as this is just what I have read and understand. Not sure about HCG as it typically just helps to boost your natural production, but it doesn’t sound like it would be that much benefit to you with the issues you’ve had.

HCG is used to mimic luteinizing hormone in your body. You do not normally produce HCG as a man. I’m guessing that it must be produced by the cancer if it’s a marker. I don’t see why it would encourage cancer growth, as you wouldn’t have any naturally normally. If it did, the LH would probably do the same thing. I’m not an oncologist though…

Why not just take the test solo?

From what I’ve read, that may be a very risky proposition.

Maybe i missed something but i only saw that it was for testicle atrophy. Which for most is a vanity thing. The risk i thought came from having HCG and messing up cancer tests. If I missed something where not having HCG also affected the cancer I apologize and retract my question.

No you’re right there. I was talking about TRT solo. Introducing exogenous T could be a risky move for him.

Exogenous testosterone can accelerate cancer growth if already present. Sounds like the OP may not have been given the 100% “All Clear” just yet.

Oh no. I would never recommend TRT solo (no doctors I believe is what you were thinking I was saying)with that background. Just meant testosterone solo minus the HCG. As that is what I got being the biggest issue.

No I got your meaning. I’m just saying that Test is not a good idea at all for him right now…

This is according to my understanding. I am not a Dr though.

Thanks for the feedback so far Bmbrady77 and rise80. My oncologist said the TRT would not be a problem. It was the HCG injections that he was questioning. And just to clarify, the HCG is not just for atrophy, but to keep my last remaining testicle functioning as close to normal as possible. If I did go the T only route, is there another way to keep the remaining testicle functioning somehow (could it stay normal with T only in my condition)?

I know I’m in “normal” range but my symptoms are another story.

Also, my current TSH of 2.62 is high? Where should it be?

Thanks!

If you use exogynous T your natural production will essentially stop. That TSH is not a big deal in and of itself, the T3 and reverse T3 are more important

He would know better than me for sure. Everything I’ve read about the cancer accelerating properties of TRT on existing cancer has been related to prostate cancer. Not sure about testicular cancer.

We typically like to see it at or less than 1. Anything above warrants (at the very least) a more thorough thyroid blood panel to verify Thyroid output.

So just take Test solo or use hcg and stop taking it for a week or whatever when it’s time to do cancer testing. If endogenous test isnt going to grow cancer i can’t understand what exogenous bio identical test would. Dr says its alright then go for it and live your life. If the cancer comes back drop your gloves and give it he’ll.

My brother-in-law is doing chemo for exactly your situation right now. He’s on the second run of chemo (2 runs of 6 weeks) and he lost one of the boys as well. The situation sucks and I feel for you. He’s dropped like 60 lbs. Do you know what your actual current test and E2 numbers are?

We’re you wanting to keep it functioning for fertility?

Hardartery- prayers up for your brother-in-law. I did 4 runs over 3 months and I lost a ton of weight. I thought the chemo was going to kill me, but thankfully it only killed the cancer. Maybe recommend to him the book “It’s not about the bike” by Lance Armstrong. i found it comforting at the time.

Rise80- Yes, I’m hoping to retain fertility if possible (my last semen analysis finally showed some viable sperm). I’ll be sure to get my T3, rT3 checked. Would you wait for those results before starting TRT? My endo was fine with the TSH result…

Anyone have good results with test solo as jimmy401 suggests?

Thanks!

There are a lot on test solo with no HCG. Me being one. Fertility though adds another variable. You could always have some swimmers frozen for when ready. Have also heard that exogenous LH is now availble for when you are ready to try impregnating. Not sure if that would affect anything with you but something you could possibly look into.

An endo on here has stated HCG should not be taken consecutively as the leydig cells could become desensitized to it. He seems to steer his patients away from it unless actively trying to concieve. Something to keep in mind.

The clomid will ramp up your production, while you are on it. It ramps up everything though, E2 as well as T. I would try a run of clomid first, personally. I wouldn’t hold my breath on long term success, but it’s definitely worth the try in your situation. I’ts really hard to know what that partially cooked teste is going to do on exogynous test, if fertility is important I would avoid TRT as long as possible just in case.

Hcg mimics LH I believe what you are referring to are fsh injections

Your probably right. I couldn’t remember exactly which one but was thinking is was LH since HCG mimics it so thought that is the one you want.