PSA undetectable but testosterone remains negligible

just had my latest PSA ( finishing 1 yrs of ADt) it was <.02 and Testostrone was < 12 but I still have hot flashes altho not as intense as 6-8 months ago.

It is normal for it to take 3-6 months for testosterone to return after the stated expiration of Lupron shots. You still have a good chance it will return in a few more months. Unlikely to be as high as pre-ADT levels.

Did you only have 1 Lupron injection (9 months ago) or did you have more than one injection and that was your most recent one?

What was your testosterone level prior to your Lupron injection(s)?

I started Orgovyx on 12/05/23 and finished on 06/05/24. Here are my values.
Date Testosterone
11/3/2023 517
12/14/2023 27
3/28/2024 14
6/28/2024 482
10/7/2024 372
1/8/2025 466
5/21/2025 590
11/18/2025 722

Stay Strong Brother, We Got This.

@brianjarvis I just had one shot. Must have bee a good one. I recall hearing that my testosterone was low but I don't recall a number.

@anosmic1 The general rule of thumb for T recovery following ADT (with the exception of Orgovyx and Firmagon) is to expect it to take about 50% longer than the ADT was planned for.

In my case, I had two 3-month injections of Eligard (April & July); expected T recovery in October, but it didn’t recover for 3 additional months (January of the next year).

With your last injection in October, you’re right at that ~9 month mark. Your next PSA test will be telling.

It’s important to know your baseline T numbers. That helps in troubleshooting should your later PSA or T numbers become unusual.

(I recall telling my wife (in 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.)

That's good to know and encouraging. The oncologist yesterday seemed baffled by my continued hot flashes, but that may be because he's always been on the other end of the needle. I'm feeling good, dealing with fatigue, and now clear for the next 3 months.

@anosmic1
Your testosterone is returning much slower than it normally would. By nine months you should already be at least 150. The fact that you are 68 usually means that it should be coming back by now, but it apparently is not.

You could get testosterone injections if it keeps staying this way. You are definitely not recovering normally.

When I was on Lupron for six years and Orgovyx for six months, I stopped Orgovyx Figuring my testosterone would never come back. Eight months later, it hit 50 and was going up 20% a month. I was 77 at the time. This is just an example of someone that has been on ADT for a long time and being much older than you having a comeback much quicker.

My brother at 77 had two Lupron 3 month Shots before and after radiation. At one year, his testosterone was over 150.

At some point, you need to talk to your doctor about testosterone injections. The feasibility of having them depend on how serious your case of prostate cancer was. Also, how well your PSA is doing. Adding testosterone can be counter productive.

Thanks Jeff. We discussed testosterone levels briefly on Tuesday and he thought waiting for the next test in 3 months is appropriate. I will see the urologist/surgeon in October and won't see the radiation oncologist until January. But I'll certainly bring it up in October and I'll ask that my blood test in October include testosterone and not just PSA.

My cancer apparently was more severe than expected. My biopsy in July 2024 pegged me at 4+3, but after the surgery (Nov 2024) I was 4+5. He told me that had I not come in when I did it could have been fatal. I can promise that is a sentence I will never forget.

I remember thinking at diagnosis 2 years ago that (after pancreatic cancer took both parents at my current age) I caught break and had an "easy" cancer. How fooling that sounds now. The journey continues.

If your PSA is not detectable, it is a good news. You testosterone numbers should be about 400 plus. It is possible that Lupron is still in your body.
I hope your PSA remain not detectable. In my case, it became detectable 16 months after the surgery. 11 years later, and diagnosed with stage 4 cancer, my PSA is 0.68.
Good luck