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PSA undetectable but testosterone remains negligible

Posted by anosmic1 @anosmic1, 3 days ago

Mostly good news from today's PSA test 7 months after the end of radiation. I'm age 68, Gleason 9, had RP in November 2024, 6-month Lupron injection in October (9 months ago) and 39 radiation treatments ending in February.

PSA is undetectable (<0.01) but testosterone remains almost nonexistent at <12. Reference range is reported as 240-1022. Saw the radiation oncologist today and he seems surprised that the testosterone score is so low still and that I continue to have hot flashes, probably 10-12 a day. He didn't take any new steps.

Next appointments are October with the urologist/surgeon and January with Red Onc.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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slick64 | @slick64 | 9 hours ago

I’m having the same issues my friend. I’ve been over treatment for 3 yrs and while not having hot flashes, but they were never intense. I had hi bean proton radiation and 2 shots eligard and one of firmagon. I was Gleason 4+3/7 intermediate. To date my testosterone has stayed in the low end and told no replacement as they don’t want to throw gas on the fire. I also consulted another doctor specializing in situations like this and sexual health. He stated that about one third of survivors that their testosterone never comes back. It seems I am in that category. Now, just this week I went in for a blood draw for my six month checkup. The results are in my file and my PSA is .11 and while my testosterone was flagged as abnormal it currently stands at 217. That’s the highest ever since treatment. I glad about it but concerned but definitely in the right direction. The journey hasn’t been easy and I’m dealing with other issues so all I can say is stay positive and try to do your best. These recent results have made the fight headed in the right direction.

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anosmic1 | @anosmic1 | 7 hours ago

One of the best things about this site is hearing from guys who have had the same experience. I certainly can't find people with these experiences among friends. I'd like to be finished with the heat surges it's all better than dealing with the side effects of the cancer.

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pesquallie | @pesquallie | 3 hours ago
In reply to @brianjarvis "@pesquallie Data show that older age results in significantly slower and less frequent testosterone recovery after..." + (show)
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@pesquallie Data show that older age results in significantly slower and less frequent testosterone recovery after stopping ADT compared to younger men. Recovery time also depends heavily on the duration of the hormone therapy and starting (baseline) testosterone levels.

> https://goldmanlaboratories.com/blogs/blog/testosterone-and-cancer-survivors-men-60

> https://www.smsna.org/patients/news/after-adt-testosterone-levels-don-t-always-recover

> https://www.curetoday.com/view/testosterone-recovery-in-prostate-cancer-may-depend-on-adt-intensity
================

Something else to discuss with your medical team —>
There is a school of thought that your "menopausal" symptoms (hot flashes, fatigue, and low libido, etc.) may not only be caused by low testosterone (due to hormone therapy), but also low estrogen that triggers many of these specific side-effects.
In men, a portion of testosterone is converted into estradiol (a form of estrogen). When testosterone drops (due to hormone therapy), the body's estrogen supply naturally drops with it. A chain of events occurs:
> a testosterone deficiency automatically means a lack of the building blocks needed to make sufficient estrogen.

> When men experience severe hot flashes, clinical studies have shown that administering estrogen alone minimizes their symptoms (https://pubmed.ncbi.nlm.nih.gov/10654902/; https://www.wellrx.com/news/estrogen-in-men/)

Again, something to discuss with your medical team.

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@brianjarvis

At age 84 my testosterone has only recovered to 118 after 12 months or about 40% of the 282 before ADT treatment. I continue to have severe headaches, bone and muscle aching, and hot and cold flashes. From all I have read, total recovery is very unlikely for me because of my age and very low pretreatment testosterone level. I only had 4 months of the prescribed 18 months of Lupron ADT because of very severe side effects. I also had heart bypass surgery 19 years ago. I know that low testosterone causes damage to the heart, bones, and muscles. In a week I will be seeing my urologist and will ask him for testosterone replacement therapy. He has already told me that he does not do TRT so we may have to part ways. Any advice on a good TRT treatment and possibly a new urologist in the Oak Ridge or Knoxville, TN area?

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