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There's a Dr. Roy who is following this.
The follwing appeared in conjuntion w his name. But I don't know if he'd go along with all of or any of it. GOOD LUCK!!
After a patient completes a course of androgen deprivation therapy (ADT), testosterone levels gradually recover. A long prostate-specific antigen doubling time (PSADT) following this testosterone recovery indicates that any remaining cancer cells are growing slowly, which suggests a lower risk of biochemical recurrence (BCR).
This "flattening" of the PSA curve compared to more aggressive disease occurs when:
Residual cancer is less aggressive: The remaining prostate cancer cells are not highly proliferative, so they respond more slowly to the return of testosterone. Their slow growth leads to a longer PSADT and a less steep increase in PSA levels.
The initial treatment was highly effective: The previous treatment, such as radiation or surgery, successfully eradicated the bulk of the more aggressive, faster-growing cancer cells. What remains is a smaller volume of more indolent disease.
How a longer PSADT happens
Several factors influence the rate of PSA increase and lead to a flattened curve after testosterone recovery:
Return of androgen sensitivity: After a period of being suppressed by ADT, the PSA-producing cells—both normal and cancerous—become re-stimulated by the return of testosterone. In cases with less aggressive residual disease, this re-stimulation causes only a slow and gradual rise in PSA, resulting in a long PSADT.
Duration of ADT: The length of ADT can impact the PSA curve. A shorter duration of ADT (e.g., 6 months) often leads to a quicker recovery of testosterone to normal levels compared to a longer course (e.g., 18 months or more). However, regardless of the recovery timeline, the slow PSA kinetics following the return of androgens are what signals a less aggressive, or "favorable," recurrence.
Lower-risk disease characteristics: A longer PSADT is consistently associated with more favorable disease features. Conversely, aggressive cancers are characterized by a short PSADT and a rapid rise in PSA.
What a flattened curve indicates
A prolonged PSADT, or flattened PSA curve, is a significant prognostic indicator. It suggests:
Lower risk of future progression: Men with a long PSADT after testosterone recovery have a significantly lower chance of progressing to clinical failure or requiring further therapy.
More time before further treatment: The slower increase in PSA allows for a longer period of observation, potentially delaying the need for further, more aggressive salvage treatments.
Improved personalization of treatment: Monitoring PSA kinetics after ADT can help doctors recognize potential failures earlier and personalize management decisions, tailoring follow-up and future interventions to the patient's specific risk level.
This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more

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