Testosterone check after Radiation and lupron

Posted by borudds @borudds, Oct 6, 2020

I am 73 and am ( was ) in good shape. Worked our pretty hard 6 days/ wk. for over 40 years. I had been on TRT for approx.18 months with a T level between 490 and 510 the past year. I was diagnosed with prostate cancer via a prostate biopsy in Feb. of '20. Prostate biopsy had 1 positive out of 12. It was a 3+3 Gleason score of 6. I had a 16 week Lupron injection on April 14th and started 39 radiation treatments on June 10. I had a 12 week Lupron injection on Aug. 4 and the last radiation treatment of Aug.5. My nuclear bone scan, Prostate MRI, Spine MRI and Pelvis/Abdomen CT scan were all negative. I just had my first follow up blood work last week. My PSA was 20 and it is now .2. My medical oncologist gave me orders for my next PSA in 6 months and said that my next Lupron ( 12 week ) shot on Oct. 27 will be the last one. He originally indicated I would be on Lupron for 18 months but this will just get me to 40 weeks. ( fine with me ) My question concerns the fact that he told me he doesn't believe there is any need to check my testosterone level. I thought that was the key reason for the Lupron injections. Has anyone else gone through this process without knowing what your testosterone level has become?

Sorry about the spelling yes Lipton it is and has been for2+ years

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Here is a question for those of you who have been on Lupron: I was given a six month Lupron shot. I was advised to take calcium and vitamin D while taking Lupron.
My question is, how long do I need to take the calcium/vitamin D supplement?
Do I stop calcium supplement when the Lupron shot has worn off, or do I take it for the rest of my life?

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I plan on taking the Calcium and D3 the rest of my life. Even if Lupron was stopped for me (which I don't think it will be). The Medical Onc. is also giving me a 6 month shot of Prolia to boost bone strength. Just as a side note if you take Calcium Carbonate it has to be taken with food. Calcium Citrate can be taken anytime. The downside – Calcium Citrate is alleged to be 20% less effective. Also, whichever you choose the body will only absorb 500 mg at a time. The rest is wasted in urine. I guess it takes a two or three hour period before next dose.

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similar story for me (I was on TRT before being diagnosed with a Gleason of 9 and a PSA of 27) but I had 26 month of Lupron and 39 Proton treatments. My oncologist was also only concerned about the PSA results- he said that is the only thing that needs to be monitored because that result is associated with cancer. The Lupron effect on my muscles, strength, weight and stamina is/was miserable. I used to routinely ride 100 mile group bike rides here in the mountains of Asheville. (I am getting back in shape with an e-bike). These onc docs don't have a holistic approach and are only focused on the cancer outcome. I have to request testosterone levels when I get my PSA. The T level had been <10 now it is at 22 and I will be requesting to go back on TRT. Current literature says there is no problem with TRT post prostate Ca therapy.

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@wilderness

similar story for me (I was on TRT before being diagnosed with a Gleason of 9 and a PSA of 27) but I had 26 month of Lupron and 39 Proton treatments. My oncologist was also only concerned about the PSA results- he said that is the only thing that needs to be monitored because that result is associated with cancer. The Lupron effect on my muscles, strength, weight and stamina is/was miserable. I used to routinely ride 100 mile group bike rides here in the mountains of Asheville. (I am getting back in shape with an e-bike). These onc docs don't have a holistic approach and are only focused on the cancer outcome. I have to request testosterone levels when I get my PSA. The T level had been <10 now it is at 22 and I will be requesting to go back on TRT. Current literature says there is no problem with TRT post prostate Ca therapy.

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Just an update from my Oct. 6, 2020 post. All needed to go around corners to get my testosterone checked. I have a doctor friend who understood and wrote the blood orders for me. My 3rd and last lupron injection was on Oct. 27 ( a 3 month injection) and had my test checked on Jan 18. It was 12. My next PSA test is on March 23 and my follow up with my medical oncologist is on March 30th. I am going to question him on how I can safely raise my test if possible. My performance at the gym is the real cause of my depression. It could be worse but I'd like it better.

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@borudds A couple of decades ago I went to an specialist in endocrinology .. she said I needed Testosterone shots.. so I did that for a while.. until I went to my Urologist and he said STOP that … we don't want to encourage the Male problem with Prostate Cancer.. I did get Prostate Cancer years later.. but I was monitored for years … Certainly I have no idea what physical exercise you want to perform better.. but Certainly wait until that Radiation Oncologist gives you his view.. As we age the athletic performance diminishes….See the following.. https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

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I had a testosterone check on my own on Jan 18, 2021. It was 12. My medical oncologist insists there is no need to have my testosterone checked while continually stating that no testosterone therapy will ever happen. My PSA on 3/19/21 was <.1 and I'll be checking it again in 6 months. I apparently still do not understand why my testosterone level isn't needed to be checked and yet according to my oncologist I will never have any testosterone supplementation under any circumstances. Any ideas?

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@borudds

I had a testosterone check on my own on Jan 18, 2021. It was 12. My medical oncologist insists there is no need to have my testosterone checked while continually stating that no testosterone therapy will ever happen. My PSA on 3/19/21 was <.1 and I'll be checking it again in 6 months. I apparently still do not understand why my testosterone level isn't needed to be checked and yet according to my oncologist I will never have any testosterone supplementation under any circumstances. Any ideas?

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Throw the BS penalty flag on your oncologist.

If you are on treatment, particularly ADT, you want to know PSA and T.

Generally, the lower your T, the better your response. Long ago and far away less than 50 was the standard, only because that’s as low as they could measure. Now, less than 20, while on ADT for 18 months mine was <7.

I don’t know about your clinical history or status so not in a position to comment but after surgery, BCR, SRT, six cycles of taxotere, 25 more radiation treatments to the pelvic lymph nodes and 18 months of Lupron we stopped treatment and I have been off treatment since August 2018. T recovered to 135 after two months, 482 by six months.

I have no doubt I will go back on treatment at some point in the future, just not now!

Also, it doesn’t cost your oncologist anything to order the T test so stand your ground.

When making decisions it is important to have clinical data, T is part of that.

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@kujhawk1978

Throw the BS penalty flag on your oncologist.

If you are on treatment, particularly ADT, you want to know PSA and T.

Generally, the lower your T, the better your response. Long ago and far away less than 50 was the standard, only because that’s as low as they could measure. Now, less than 20, while on ADT for 18 months mine was <7.

I don’t know about your clinical history or status so not in a position to comment but after surgery, BCR, SRT, six cycles of taxotere, 25 more radiation treatments to the pelvic lymph nodes and 18 months of Lupron we stopped treatment and I have been off treatment since August 2018. T recovered to 135 after two months, 482 by six months.

I have no doubt I will go back on treatment at some point in the future, just not now!

Also, it doesn’t cost your oncologist anything to order the T test so stand your ground.

When making decisions it is important to have clinical data, T is part of that.

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I would coordinate the tests through my Urologist.

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Can I ask where you're having treatment?

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At Mayo MN when they confirmed that I had Prostate Cancer my first stop after talking with the Radiation Oncologist was to get the 3 month Lupron Shot.. 2 months after that shot my Radiation Started ..From the Lupron site: "Lupron is a type of hormone therapy for prostate cancer. It works by lowering the amount of testosterone in a person's body, which helps slow the growth of cancer cells. Doctors often prescribe hormone therapies in combination with radiation therapy or following surgery. Feb 18, 2019" It makes sense to me that getting more Testosterone is feeding the tendency to get Prostate Cancer .. There is a balancing act here and certainly it is your life … but who knows more about success rates from prostate cancer than your Oncology Doctors.. They are part of the team to extend life.

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