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I can’t believe your doctor would tell you that if your testosterone rises above such a minimal level, you need your testicles removed. I have never heard of anything even close to that. As long as your testosterone is below five it is just as effective as being below 1.7. I would ask the doctor to show you documentation that would justify needing the removal of the testicles. Taking Erleada blocks androgen (male hormone) receptors on prostate cancer cells, preventing testosterone and other androgens from fueling cancer growth. So having a low testosterone level is not so critical while you’re on that drug (or on Nubeqa).
One major study, the stampede study, looked into the rise of testosterone and many other issues, it showed if it rose over 50 that was a problem not 1.7.
You are beyond the expertise of a urologist you should be going to a center of excellence and getting treatment from an Oncologist that specializes in prostate cancer.
Instead of diphereline 3.75. You should ask the doctor about putting you on Orgovyx, A pill you take once a day that’s much easier than getting an injection. It is just as effective.
Another thing you should request is switching Erleada (apalutamide) to Nubeqa (Darolutamide) because it has a fewer side effects and works just as well. It also doesn’t pass the blood brain barrier, which can cause brain fog.
Replies to "I can’t believe your doctor would tell you that if your testosterone rises above such a..."
@jeffmarc I suspect his testosterone is being measured in nmol/L, not ng/dl. So you would multiply ny 28.8 to convert. So 1.7 would be about 49
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@jeffmarc
Oh, Jeff. Thanks for reply!
Nubeqa and Orgovix not available for me (according to the conclusion of the medical council, Erleada, Diphelerin, and Zoladex were prescribed)
Almost all metastases have been destroyed by chemotherapy or are dormant. My oncologist says that if my PSA is 0, then "there's nowhere to shoot," BUT, the expression in the tumor itself remains (this info on January 2025 before Erleada). I'm concerned that after six chemotherapy sessions and ADT (Zoladex 10.8), my PSA only dropped to 12. After two additional chemotherapy sessions, it dropped to 8. I understand that after a PSA of 531, it was difficult to lower my PSA. In other words, it didn't drop to 0. It was after this that Erleada was prescribed, after I pushed the doctors hard!
In January 2025, my PSA was 6.9, testosterone 1.13 (before Erleada).
In February, I started Erleada and replaced Zoladex 10.8 with Diphelerin 3.75, as recommended by my oncologist.
In March 2025, PSA 1.21, testosterone 1.36
In August 2025, PSA 0.12, testosterone 1.55
In November 2025, PSA 0.04, testosterone 1.61 (after taking Erleada and Diphelerin 3.75 after 9 months)
Even here on the forum I read a lot about the fact that the lower the testosterone level, the better and this level should not be higher than 0.7 to exclude risks with Gleason 9
By the way, I should mention that I had high cholesterol, very high – 8.
I started taking statins in October 2025 and lowered it to 4. Perhaps this affected the growth of testosterone; in 3 months (I repeat), it increased slightly by 0.06 I mention this because testosterone synthesis depends on cholesterol, and there are heart risks. There's some information that lowering cholesterol leads to lower testosterone levels. Have you seen this information?
Thank you so much for participating in the discussion, Jeff.