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ADT, Hot Flashes and Ashwagandha: Is it safe?
Prostate Cancer | Last Active: 11 hours ago | Replies (11)Comment receiving replies
Since the last 3 month Lupron injection was in June, I would assume "treatment" ended around September, so it has been 2 months off of treatment? I would also assume that PSA will begin to rise on its own at this point. How do you judge when treatment is done? Still suffering major hot flashes and poor sleep quality. I'm looking to get a little additional boost to the natural increase in testosterone with the hope that this will bring some control to the hot flashes. As I understand it, you don't want more than a 2.0ng/ml rise in PSA after ADT with an intact prostate. I'll be getting the ultrasensitive PSA blood test in a couple of weeks and I believe the plan is to get a test every three months, so I should be able to monitor the PSA regularly.
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@slowdo If you’re tracking testosterone (T) levels, that will indicate when treatments have ended.
> what was your T level before starting ADT?; what is your T level now? (If T levels are still low, that may explain why you’re still suffering major hot flashes and poor sleep quality.)
Your PSA should increase slightly once the ADT leaves your system and T levels begin to rise significantly. I would wait until then before considering a testosterone boost,
Actually, a 2.0ng/ml rise in PSA above nadir (called the Phoenix Criteria) is the clinical definition of biochemical recurrence (BCR) following initial radiation. That’s a number you don’t want to reach. (See attached chart showing my PSA at the start, during, and since radiation. If my PSA ever exceeds 1.0ng/dL, we’ll start discussing next steps well before a 2.0ng/ml rise in PSA has occurred.)
In addition to regular testing of Total PSA going forward, you’ll want them to also test and track:
> Free PSA
> PSA Velocity
> PSA Doubling Time
> A separate question: Did you have a DEXA scan prior to starting ADT?
Also, they should be checking all of your other bloodwork (i.e., CBC & CMP) to ensure that the radiation treatments haven’t caused any other issues.