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Learned Something New Last Week

Posted by capatov @capatov, Jul 29, 2025

While meeting with my NP 3 months post IMRT and HDR treatment for Gleeson 4 +3, PSA 7.1 I learned something new.

When I asked if my 3 months post-treatment PSA going from 7.1 to 0.04 could be largely due to the fact that I was on my last week of 6 months Orgovyx/ADA therapy vs. the impact of the radiation.

She informed me that while the ADT does help lower the PSA...many men never get near zero after treatment even if still on ADT. She said "if there was any cancer present in your body...your PSA would be no where near zero. She said feel good about your prognosis."

I left my appointment feeling positive to be sure.

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jeff Marchi | @jeffmarc | Jan 25 11:52am
In reply to @pesquallie "@robertov There are recent independent Harvard, Duke, and Swedish studies that say for aggressive prostate cancer..." + (show)
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@robertov

There are recent independent Harvard, Duke, and Swedish studies that say for aggressive prostate cancer some men benefit from a higher or normal level of testosterone. Duke is doing AI based research to determine what are the characteristics to determine which men benefit from higher testosterone. This could take many years. For now, follow your doctor's advice.

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@pesquallie
The studies that have been done, have shown that after somebody has become castrate resistant, they can be given testosterone, and it will kill off some of the cancer that has grown immune to low testosterone and started spreading.

There are a number of studies about BAT, which is where they give testosterone injections to people that have Become resistant to the drugs. They can reset their systems to the point that they can start taking drugs like Zytiga again.

High testosterone when you are first diagnosed is not going to help. It’s later when the cancer has become able to grow without testosterone that it becomes Beneficial.

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pesquallie | @pesquallie | Jan 25 2:07pm
In reply to @jeffmarc "@pesquallie The studies that have been done, have shown that after somebody has become castrate resistant,..." + (show)
Profile picture for jeff Marchi @jeffmarc

@pesquallie
The studies that have been done, have shown that after somebody has become castrate resistant, they can be given testosterone, and it will kill off some of the cancer that has grown immune to low testosterone and started spreading.

There are a number of studies about BAT, which is where they give testosterone injections to people that have Become resistant to the drugs. They can reset their systems to the point that they can start taking drugs like Zytiga again.

High testosterone when you are first diagnosed is not going to help. It’s later when the cancer has become able to grow without testosterone that it becomes Beneficial.

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@jeffmarc

Yes, you are right, but Duke is trying to predetermine who will benefit from normal testosterone levels. They have not yet been able to determine what men will benefit and it may not just be just those whose cancer has become immune to low testosterone. Also determining when cancer low testosterone immunity starts is very difficult.

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jeff Marchi | @jeffmarc | Jan 25 3:23pm
In reply to @pesquallie "@jeffmarc Yes, you are right, but Duke is trying to predetermine who will benefit from normal..." + (show)
Profile picture for pesquallie @pesquallie

@jeffmarc

Yes, you are right, but Duke is trying to predetermine who will benefit from normal testosterone levels. They have not yet been able to determine what men will benefit and it may not just be just those whose cancer has become immune to low testosterone. Also determining when cancer low testosterone immunity starts is very difficult.

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@pesquallie
Duke did complete this study in 2024 That shows what I was talking about.. Using BAT in advanced cases.
https://corporate.dukehealth.org/news/study-solves-testosterones-paradoxical-effects-prostate-cancer
Are you familiar with a study they are doing that Is looking for anything different?

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pesquallie | @pesquallie | Jan 25 5:02pm
In reply to @jeffmarc "@pesquallie Duke did complete this study in 2024 That shows what I was talking about.. Using..." + (show)
Profile picture for jeff Marchi @jeffmarc

@pesquallie
Duke did complete this study in 2024 That shows what I was talking about.. Using BAT in advanced cases.
https://corporate.dukehealth.org/news/study-solves-testosterones-paradoxical-effects-prostate-cancer
Are you familiar with a study they are doing that Is looking for anything different?

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@jeffmarc

If I understood correctly, a more recent report says they are planning to determine the individual's prostate characteristics that determine when normal testosterone is beneficial. I think the AI based study will look at many physical attributes for each patient and then build a method that determines when to use high testosterone levels.

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robertov | @robertov | Jan 26 10:24am

Thanks, good to know. I am following generally standard advice. 18-24 months of ADT. I’ll probably opt for the lower end.

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robertov | @robertov | Jan 26 10:42am
In reply to @vircet "@robertov I assume that 5.74 was pre-treatment and that the next twe were after 3 and..." + (show)
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@robertov I assume that 5.74 was pre-treatment and that the next twe were after 3 and 6 months on ADT, with one year of ADT to go. Is that right?
You mentioned that you will not know until after you stopped ADT. I was told the same thing by my oncologist.
I was on Orgovyx for 6 months only. My PSA history is 7.9 & 10.05 two months apart pre-treatment. 0.3 & 0.22 after 3 & 6 months on ADT, 0.99 at three months after stopping Orgovyx. My radiation the rise in PSA is not a concern, it's expected with my testosterone recovery.
I have yet to see how high my PSA will be, before it starts going down to my nadir. It can be a long wait, I guess one to 2 years.

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@vircet Yes. Pre-treatment, 5.74, after 6 months and then right after radiation. Everything you say sounds like what I’m beginning to understand. My ADT wasn’t going to be recommended for only 6 months due to Gleason 8.

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