51yo Canadian man with history of cryptorchidism and cancer, looking for a path forward

[islandtime50]

I'm 51. About 4 years back I was in great shape — and by that I mean two workouts a day, except on run days when it was just one, with a single rest day each week unless I got hurt. Then over the last 4 years things went off a cliff: I began a new career, COVID hit all of us, and I learned I had colon cancer.

As far as that goes, the cancer is as wrapped up as it can be — my prognosis is the best you could ask for given that I carried a tumour for 8-10 years, had it invade surrounding tissue, and got so run down that at one point I would have accepted that it was my time. Evidently 46 sites around what used to be my colon were sampled and every one came back negative, and I don't even need chemo ... see you in 6 months. Based on those unexpected results I was downgraded from stage 3 or 4 to 2.

Six months have passed since then. My diet has changed, I really can't drink alcohol, creatine no longer agrees with me, and for the first time in my life I'm not making any physical or fitness progress.

I'm 51 for the first time, my energy still hasn't come back to the level I'm hoping to regain, and I'm stuck at 220lbs and 29%bf compared to my former glories.

There's also a neat little scar low on my abdomen, just inboard and below my right hip bone (inguinal, I believe), that's 45 years old now. One testicle refused to descend, so at age 6 I had an orchiopexy. Almost by definition that makes this a case of hypogonadism from birth, since male hormones are what drive most of that process when it happens on its own.

SIDE NOTE - Because of this I have one small, underdeveloped testicle that I'm also supposed to monitor for cancer. It isn't supposed to work very well, but I can tell you it produces swimmers, because when I tried to spare my wife the burden of birth control I went for a vasectomy. The expert in that area actually hurt me badly by doing the vasectomy on the presumed functional twin, chose to leave the little fella alone, and the follow-up lab results showed we would still make babies (something I/we never had trouble with before), which made the whole thing not only painful and infuriating but ultimately pointless. Beware rich little bored men with knives.

During those 4 years, along with my 50th and 51st birthdays, cancer and weight gain, another thing happened ... no more wood. No real drive for it either, and well, we aren't going to make any babies anyway. That's a pretty noticeable little change, can't recommend it. My wife never had the same drive I did, so honestly I think she's quite relieved. For me, though, this is a problem.

So the small ball thing first, I think. It's been a lifelong thing and not something I've really talked about. I can assure you there's a lot of casual glancing near urinals and in communal showers during sports or at the municipal pool. I've noticed (and it's been noted) that I'm not built like everyone else, or at least, on the spectrum of male sexual physiology I run a little off the bumpy part of the bell curve. It hasn't really been much of an issue since puberty. But I'm a low T guy and always have been, I just never thought of it that way.

Now I'm thinking about it, though. I'm thinking TRT. My doctor (we're new to each other since just before the cancer was found) won't be any help. In fact, anti-depressants are the only answer he has for me. I'll admit I was down before the emergency, life-saving bowel resection, but it took 4 years of no results, a relatively late career change (and the poverty that comes with it), and nearly dying to get there. I am strongly uninterested in, if not opposed to, anti-depressants. New blood work is going to be necessary. In late Feb I was at 11.6nmol/L. I also have a ferritin problem (originally from bleeding from my tumour), and a weird high RDW on my CBC that could be from that or from the infusion I got right before surgery. Anyway, the long and short is I have a doctor I don't know well or trust, and he's not going to help with any of this.

I want to look at optimal testosterone levels via trt and then follow up with tirz or reta once that is stable. From what I can see, I'm looking at UpGuys as a telehealth for trt or simply going grey and getting blood work through teletest.ca. I live around the mid-point of Vancouver Island in B.C.

I have an appointment with my doctor this week and I've thought about trying to get a referral for an endocrinologist or a urologist, since what I have falls in their respective wheelhouses. However, I feel the current state of health care looks excellent for life-saving interventions and absolutely shit for actual health. Health and wellness look to have been sold off to third parties.

Questions? Comments? ... Dirty Jokes?

 

[Clavicular's Hammer]

I'd suggest trying Reta first, with TRT coming later.

Dropping a bit of weight could bring back some self-assurance and endurance. Adipose tissue behaves somewhat like an organ: it sends out hormones and drags on your energy.

Reta should also assist with accumulated visceral fat, retained water, and inflammation, so you'd likely notice a real lift.

Compared with TRT, Reta carries fewer long-term things to weigh. That makes it worth giving a try.

 

[lessthanhalf]

Where I live—Australia—the usual guidance for someone with low t who carries extra weight is to drop pounds first. That strategy doesn’t appeal to me much. Still, if you begin a GLP such as reta and shed some weight, your t levels have a decent chance of rising, which could make additional t unnecessary. In the US, older men whose test levels are on the low side are frequently given test therapy. Canada’s approach? I have no clue; my guess is it may resemble Australia’s, with endocrinologists as the only prescribers.

Recent research found a large rise in average life expectancy among colon cancer patients receiving GLP therapy. That is far from established, yet numerous early trials indicate comparable outcomes—one involving breast cancer—and plenty of preclinical work suggests the same direction. That gives another potential rationale for glp treatment. Since reta isn’t approved, no cancer research on it exists yet, although in other contexts it appears to deliver most of the same effects as tirz and sema.

Whether test therapy affects cancer growth is unknown to me. My recommendation: before moving forward, seek a specialist’s view (endocrinologist / oncologist). If not, at minimum run some google scholar searches.

 

[cujet]

Somewhere on this forum there is a link covering how GLP1's and Retatrutide lower cancer risk and improve cancer survival. Worth searching it out, since it could be relevant in your case.

 

[islandtime50]

Clavicular's Hammer said:

I'd suggest trying Reta first, with TRT coming later.

Dropping a bit of weight could bring back some self-assurance and endurance. Adipose tissue behaves somewhat like an organ: it sends out hormones and drags on your energy.

Reta should also assist with accumulated visceral fat, retained water, and inflammation, so you'd likely notice a real lift.

Compared with TRT, Reta carries fewer long-term things to weigh. That makes it worth giving a try.

To start, I appreciate you replying! I’m new here and, to be honest, I’m trying to put together a plan.

People have made cases in both directions. Right now I’m 183cm (6') and weigh 98kg (226lbs). That’s not completely out of hand, but I’m definitely not thrilled with it either. According to my Renpho scale, I’m at 17.5% body fat (this morning it was dead, and then charged all day). As for BMI, let’s not even go there—that number has always been way off for me.

I realize dropping weight may improve test, and I realize I’m currently taking in too many calories. In the past I have kept a very tight rein on calories and macros, and I know I can do that again. Still, I’ve never experienced energy this low for this long a stretch in my life.

Thanks once more.

 

[islandtime50]

lessthanhalf said:

Where I live—Australia—the usual guidance for someone with low t who carries extra weight is to drop pounds first. That strategy doesn’t appeal to me much. Still, if you begin a GLP such as reta and shed some weight, your t levels have a decent chance of rising, which could make additional t unnecessary. In the US, older men whose test levels are on the low side are frequently given test therapy. Canada’s approach? I have no clue; my guess is it may resemble Australia’s, with endocrinologists as the only prescribers.

Recent research found a large rise in average life expectancy among colon cancer patients receiving GLP therapy. That is far from established, yet numerous early trials indicate comparable outcomes—one involving breast cancer—and plenty of preclinical work suggests the same direction. That gives another potential rationale for glp treatment. Since reta isn’t approved, no cancer research on it exists yet, although in other contexts it appears to deliver most of the same effects as tirz and sema.

Whether test therapy affects cancer growth is unknown to me. My recommendation: before moving forward, seek a specialist’s view (endocrinologist / oncologist). If not, at minimum run some google scholar searches.

I appreciate your input as well!

Regarding TRT, my sense is that Canada's approach resembles Australia's more than the US one. Even so, from what I can see, nearly every city has a wellness clinic that does a busy TRT business, and online telehealth services are definitely starting to become available.

Doctors here seem to want a level under 8nmol/L; my own level is 11.6 (I checked my latest lab). For the US, anything under 12 seems sufficient.

I had come across GLP being linked in a positive way to improved cancer outcomes, though if I recall correctly, the proposed mechanism involved a broad drop in inflammation and similar factors.

Testosterone seems to attract more debate. There is some (disputed) worry about prostate effects. A great deal of fairly recent research appears to largely challenge older assumptions that TRT might raise cancer risk.

It appears BC Cancer is not available to me now, given the strongly negative results I got after surgery. I understand that a consultation happened with at least one person, but my GP and surgeon are the only ones I have actually met. An endocrinologist seems like my best bet, and I was already intending to ask for a referral. I have just discovered that online endocrine referrals are another pathway too.

Thanks once more. There is plenty for me to consider.

 

[islandtime50]

cujet said:

Somewhere on this forum there is a link covering how GLP1's and Retatrutide lower cancer risk and improve cancer survival. Worth searching it out, since it could be relevant in your case.

Much appreciated, cujet!

I'll check it out.

 

[Gr33dyOctopus]

I’d started leaning toward injecting myself and only using lab work to keep tabs on my blood, but that plan was shot down quite firmly on GLP1Chat and reddit. The takeaway was that going through a physician at a legitimate clinic is strongly preferred—even if many of those places seem to exist largely to empty your pockets.

Because of that I backed off (though I did pin testosterone for the first time earlier this week) and I’m continuing to look into all of it.

At the moment, what I’m reading is the r/testosterone wiki..

We share an age, and I’m sorry about the cancer misfortune—my own colonoscopy was recent, too.

 

[islandtime50]

Gr33dyOctopus said:

I’d started leaning toward injecting myself and only using lab work to keep tabs on my blood, but that plan was shot down quite firmly on GLP1Chat and reddit. The takeaway was that going through a physician at a legitimate clinic is strongly preferred—even if many of those places seem to exist largely to empty your pockets.

Because of that I backed off (though I did pin testosterone for the first time earlier this week) and I’m continuing to look into all of it.

At the moment, what I’m reading is the r/testosterone wiki..

We share an age, and I’m sorry about the cancer misfortune—my own colonoscopy was recent, too.

Thanks, Gr33dy!

That thread is now done on my end. Tomorrow I’m scheduled for a call with UpGuys (a Cdn TRT clinic), and Thursday I see my GP.

My GP probably won’t do much—at best, an endocrinologist referral. What I really want right now is updated labs. The previous results showed elevated rdw and low ferritin; all other markers came back normal (since a comparatively low test level is treated as normal in this country).

From what I can tell, UpGuys charges $50 for the consult and then probably $200-300 each month for test. I’ll have a clearer idea tomorrow, and again on Thursday.

For several years I’ve been a lurker on Reddit, especially in GLP and TRT threads.

Making any quick choice would be too soon; iron has to improve or be corrected first (I keep taking iron supplements for now, until results indicate otherwise). I’ve resumed both workouts and running, but my levels remain low.

 

[lessthanhalf]

islandtime50 said:

lessthanhalf said:

Where I live—Australia—the usual guidance for someone with low t who carries extra weight is to drop pounds first. That strategy doesn’t appeal to me much. Still, if you begin a GLP such as reta and shed some weight, your t levels have a decent chance of rising, which could make additional t unnecessary. In the US, older men whose test levels are on the low side are frequently given test therapy. Canada’s approach? I have no clue; my guess is it may resemble Australia’s, with endocrinologists as the only prescribers.

Recent research found a large rise in average life expectancy among colon cancer patients receiving GLP therapy. That is far from established, yet numerous early trials indicate comparable outcomes—one involving breast cancer—and plenty of preclinical work suggests the same direction. That gives another potential rationale for glp treatment. Since reta isn’t approved, no cancer research on it exists yet, although in other contexts it appears to deliver most of the same effects as tirz and sema.

Whether test therapy affects cancer growth is unknown to me. My recommendation: before moving forward, seek a specialist’s view (endocrinologist / oncologist). If not, at minimum run some google scholar searches.

I appreciate your input as well!

Regarding TRT, my sense is that Canada's approach resembles Australia's more than the US one. Even so, from what I can see, nearly every city has a wellness clinic that does a busy TRT business, and online telehealth services are definitely starting to become available.

Doctors here seem to want a level under 8nmol/L; my own level is 11.6 (I checked my latest lab). For the US, anything under 12 seems sufficient.

I had come across GLP being linked in a positive way to improved cancer outcomes, though if I recall correctly, the proposed mechanism involved a broad drop in inflammation and similar factors.

Testosterone seems to attract more debate. There is some (disputed) worry about prostate effects. A great deal of fairly recent research appears to largely challenge older assumptions that TRT might raise cancer risk.

It appears BC Cancer is not available to me now, given the strongly negative results I got after surgery. I understand that a consultation happened with at least one person, but my GP and surgeon are the only ones I have actually met. An endocrinologist seems like my best bet, and I was already intending to ask for a referral. I have just discovered that online endocrine referrals are another pathway too.

Thanks once more. There is plenty for me to consider.

The paper I had in mind is "Association between glucagon-like peptide-1 receptor agonists and colorectal cancer survival: A population-based cohort study."

Diabetes Metab 2026 Mar;52(2):101734.

doi: 10.1016/j.diabet.2026.101734. Epub 2026 Jan 16

The findings they reported: GLP1-RA users had a significantly lower all-cause mortality rate, 11.5%, against 20.4% for non-users, hazard ratio 0.58 (95%CI: 0.45-0.76; P < 0.001). Metastasis-free survival was 5.3% in the GLP1-RA cohort versus 8.9% in the matched non-user cohort, hazard ratio 0.60 (95%CI: 0.40-0.87; P = 0.01).

If that holds up—and it's a big if—cutting metastasis and mortality each by half could make it more potent than many standard malignancy treatments. Even now, the evidence is probably stronger than what backs many alternative or supplement-style therapies. If I were in that situation—and thankfully, despite decades of ulcerative colits, a recent scope for me was clean—I'd think about it given the current data, even though no physician will actually say that yet.

You seem to have a reasonable handle on the TRT options and the messed-up politics around them. If women were blocked from HRT the way men are denied TRT, there'd be an enormous uproar. It isn't purely that, but I suspect sexism and odd beliefs that men raising testosterone is a form of cheating play a role. TRT clinics exist as a reaction, yet they often hand it out to anyone who asks, which may swing too far the other way.