Transition out of ADT therapy

Have you been getting blood test to tell you what your testosterone level is? You need to know this so you can see if it’s rising regularly. For some people, it doesn’t rise more than a little bit, for others. It comes back close to normal. A lot depends on how long you were on it And how old you are.

When I was 77 I stopped ADT for eight months, After being on it for six years. At that point, my testosterone hit 50 and was going up 20% a month. My oncologist wanted me to go back on it because I have a genetic problem. Just an example so you know it can return, Just don’t know how long it will take.

A doctor, I hear from once a month wrote this in his newsletter.

After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.

If your testosterone has not returned to a decent level >250 After a year or so, you can get testosterone injections, which can return you to normal. Whether or not you do, this is dependent on the aggressiveness of your prostate cancer. If it’s real aggressive, you don’t want to do it Since it can cause it to come back.

For me there was no “transition.” After my 2nd (& final) 3-month ADT injection (Eligard), we simply stopped.

(I recall telling my wife (in late January 2022), that I thought the Eligard was wearing off because I was beginning to lift heavier weights at the gym. Since I wasn’t due for another “official” bloodwork for another couple of months, I self-ordered another PSA & testosterone test (out of curiosity), and those came back as 0.13 & 403.0, respectively, meaning that everything was going exactly as expected - that is, PSA staying low and testosterone increasing as the Eligard was leaving my system. The muscle mass, and strength all slowly returned.)

@jeffmarc I started ADT today for the next six months.🙏🏻

@beshoe66
Hopefully, you will have very few side effects. Went to dinner With a couple a week ago. Husband had started Orgovyx Two months before and had no side effects at all. Some people can handle it well. He has no fatigue like me.

@jeffmarc I'm curious about your comment that T injections can cause prostate cancer to come back. I am very aware that T injections can fuel the fire if the cancer comes back, but does it actually cause the cancer to come back? Thanks

@chippydoo
Testosterone injections only work for about 50-60% of people from studies I have read about using BAT. 40-50% of them have their PSA start rising too much right away due to it feeding the prostate cancer. People with serious castrate resistant issues are more likely to get benefit as it kills off those cells.

The thing is, there’s a lot of controversy about this. No specific reoccurrence rates are seen with different groups of patients.

Even people who are castrate resistant have many cells that are not castrate resistant and can immediately react to additional testosterone, by growing.

Hmmm

You say..."specializes in the transition from ADT therapy..."

So, five months ago you came off systemic therapy.

Any oncologist or urologist, well, any worth a darn, should be able to formulate a plan with you.

That plan should include frequency and types of labs, consults.

Set expectations as @jeffmarc has laid out.

Recovery of T is a function of age, baseline T, which agent(s) you were on and for how long.

There should be discussion about diet and exercise, things you control, what T level constitutes sufficiency, 300, 400, , 500...there should also be discussion about TRT should you not recover T and quality of life is impacted.

Both times after I completed systemic therapy my T recovered to 400+ in the first year.is 61+ coming off 18 months of Lupron and 67+ coming off 12 months of Orgovyx.

I have a pretty active lifestyle, did that okay a ride in my case, maybe.

Kevin

@jeffmarc Very interesting. Thank you for your time.