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Testosterone levels are rising after cessation of ADT
Prostate Cancer | Last Active: Sep 20 9:30pm | Replies (30)Comment receiving replies
I am stage 4a, grade 5, have had surgery, radiation and am currently 18 months into ADT therapy.
My PSA is undetectable still, my but testerone has jumped up to normal levels while still undergoing ADT injestions.
Wondering if I am now jumping into castration resistance phase.
Replies to "I am stage 4a, grade 5, have had surgery, radiation and am currently 18 months into..."
Something doesn’t sound right. I’ve NEVER heard of anyone taking ADT that didn’t lower the testosterone. And I’ve been in this battle for 10 years now. Definitely do a redo on your lab work.
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Castration-resistant prostate cancer (CRPC) is defined as:
PSA or cancer progression despite testosterone being kept at castrate levels (usually < 50 ng/dL).
So if your testosterone has climbed back into the normal range, by definition your cancer is not considered castration resistant. It simply means the ADT isn’t suppressing testosterone as intended, or that you’re in an “off-cycle” if you’re on intermittent ADT.
The key thing is that your PSA is still undetectable. That shows your cancer is currently under control. If it were truly castration resistant, we’d expect PSA to start rising while testosterone stayed low.
It would be a good idea to review this with your oncologist:
Double-check your testosterone and PSA with repeat labs.
Clarify whether your treatment plan is continuous or intermittent ADT.
Make sure your medications and dosing are working as intended.
For now, an undetectable PSA is excellent news. The fact that your testosterone is higher doesn’t mean castration resistance — it just means the picture needs a little more clarification with your care team.