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What if this prevents cancer from becoming resistant?
Prostate Cancer | Last Active: 59 minutes ago | Replies (52)Comment receiving replies
Yes, guys, thank you very much for the information, and a special thanks to Jeff.
Two main questions.
1. If the PSA has dropped to zero, how long should it take (six months, a year, or more) before trying to wean off ADT?
2. Does testosterone deficiency (ADT) cause resistance. How long should I stop it and monitor my PSA monthly?
My calculations may be incorrect.
Regarding 1.
It depends on the speed at which the PSA dropped to zero (in my case, it took almost a year and a half to drop to zero). If it takes a long time, we wait longer and then stop ADT.
Regarding 2.
I believe it depends on the extent of the lesion before treatment, the initial PSA, and the Gleason score. The higher the PSA, the higher the Gleason score, the shorter the break period. For example, for those with a Gleason score of 9, the break should last six months (at this point, you should try to increase testosterone by any means necessary), while for those with a medium/low Gleason score, the break can last one year.
And another thing: question two depends on the testosterone growth rate. If it grows faster (in younger patients), then the break period can be shorter.
In other words, the main variable is the rate of testosterone growth, so that the cells "recognize" its presence and don't transform.
I'll discuss this with my doctor and post the results here.
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@denis76
After being on ADT for seven years, I stopped taking it while I was on Nubeqa. I was 77. My Testosterone rose at a pretty good rate hitting 50 in eight months. The second and third month it went up over 75% a month. When it hit 50 it was going up 25% a month for the last four months. My oncologist wanted me to go back on because of my BRCA2, So I never found long-term results. My PSA stayed undetectable the whole time.
Some people don’t have T come back at all.
Waiting one year, undetectable, is what a lot of doctors recommend. It can depend on your Gleason score and other aggressive problems, however. If you are a Gleason nine or 10, you might want to wait 18 months. At least that’s the recommendation that Rick Davis over at ancan.org Gives to people. He’s been helping people for 17 years and has found that those that have more severe cases have it come back sooner. The doctors in the meetings agree with him.
You would expect the PSA to drop to undetectable < .1 Within three or four months of starting ADT. If that didn’t happen then waiting longer to stop ADT may make sense. Did you have radiation as your primary treatment? That can be a factor in PSA, not dropping since it takes a long time for the cells to die for some people. It still should not take that long for the PSA to become undetectable, definitely unusual.
How often you should monitor you PSA depends on your prostate cancer case. If it was very aggressive, you probably want to continue it for at least six months to a year. If it’s not as aggressive, maybe three months of monthly and then three month tests. Since your PSA took so long to become undetectable, I would want PSA test monthly for at least six months.