Connect
Rising testosterone during treatment
I have been in systemic treatment for four years now. My PSA has remained undetectable the entire time. However, my last blood test showed an increase in my testosterone level from < 10 ng/dl to 18.4 ng/dl in 3 months. My oncologist seems unconcerned and says we won't talk about it until, and if, my testosterone level reaches 50 ng/dl.
I guess my question is two-fold: 1) why did my testosterone level rise, and 2) should the rise be dealt with now by switching to a different testosterone suppressant.
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
Are you on ADT? if so I would want to know why my Testosterone is rising?
-
Like -
Helpful -
Hug
1 ReactionYou say you were on systemic treatment, What do you mean by that? That could mean many things. Are you on an ARSI? If your testosterone continues to rise, then Zytiga should get it back down. Studies have shown when your testosterone reaches 50 chances of your PSA rising goes up as well. You could speak to your doctor about getting you on Zytiga Or a drug like Nubeqa Which works even if you have testosterone. If you are not on an ARSI your chance of becoming castrate resistant is much higher than if you do get on one. Studies have shown that this is really important for people to do. Again, something to talk to your doctor about.
My testosterone has blipped up a couple of times, but it never left castrate range (which is < 50 ng/dl the way you measure it in the U.S.), and was always back to its typical level at the next 3-month blood test. I understand why you're concerned — I jump at any small change in my bloodwork, too — but one slight outlier result doesn't make a trend.
-
Like -
Helpful -
Hug
3 Reactions@jeffmarI
I have been on doublet therapy all four years. Lupron (3 m0nth shot) and Abiraterone (1000 mg) daily and prednisone (50 mg) daily.
FWIW, I had TWO post-ADT testosterone tests taken from the EXACT SAME blood sample (for two different doctors in the same institution, not sure why they didn't just share the results) and the results were 40 points apart. It could just be the lab. I'd ask for another test in a month or so and if it goes up again then it might be worth pursuing.
-
Like -
Helpful -
Hug
2 Reactions@higginslake
Abbie should get your testosterone significantly below 20. What your doctor says about being under 50 is what clinical studies have shown. It is quite rare for it to be so high when you’re taking both drugs.
If your testosterone keeps rising you could get on Darolutamide which keeps the PSA low even if testosterone is higher. It also has a lot fewer side effects than abiraterone. Something to discuss with your doctor if that happens.
-
Like -
Helpful -
Hug
1 Reaction@higginslake, have you been able to discuss the rising testosterone with your oncologist? What did you find out?