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Cancer: Prostate Message Board


Cancer: Prostate Board Index


Re: Testosterone:
Apr 8, 2009
[QUOTE=Dickiedo;3949825]Does anyone know what your testosterone level shoul be ??

[COLOR="DarkGreen"]Hi Rich,

Hope you had a great time in Florida. Yes, I can definitely handle that question! (Knowledge from the School of Hard Knocks.) I'll insert some comments in green.[/COLOR]

I have had PC operation in 1995, recurrence in 2000, 39 EBR treatments, then in 2007 my PSA started rising again so they started giving Zoladex every three months. I had my testossterone tested this past February and mine is
23 L. My Oncologist didn't think I needed the test but I had it anyway.

[COLOR="darkgreen"]Good for you :cool: for insisting. It's possible that your PSA is so low that the oncologist knows the testosterone must be low enough. However, some men (about 10%) do not respond well to Zoladex (or Lupron), so it's definitely worth a check now and then, partly to know just how your system is behaving in response to the drug.

From what I've learned, the ideal is to get the testosterone to 20 or below, but 23 is not bad in response to a LHRH-agonist drug like Zoladex, Lupron, Viadur, Trelstar, etc. I've found that many doctors involved in research use a testosterone value of 50 instead of 20 as the indicator of success of hormonal therapy. While they would be happy to see a patient on Zoladex with a testosterone of 23, from what I've learned, that is much too high. In other words, it's a lot less likely that the hormonal blockade will do a good job controlling the cancer.

Here's my own experience. On my second round of intermittent blockade, I remember my testosterone being around 21, yet I believe my PSA was less than 0.01 at the time. Right now, around the sixth month into my third round of blockade at the nine-plus year point of intermittent treatment, my testosterone is 28 (as of a couple of weeks ago). (I'm concerned about that, and I'll probably try for another test in a week or so, well before my next Lupron shot. Dr. Charles Myers, who is expert in hormonal therapy, told me that sometimes the body starts producing antibodies to the Lupron (or Zoladex), making it less effective; he said a simple solution, if that is the case, is to switch to one of the equivalent drugs, each of which is based on a different protein, so those antibodies are not able to link up with the new protein after you switch the Lupron/Zoladex type drug. My PSA is dropping (September 3 9.53 before starting Lupron, Lupron on September 26, November 12 PSA 2.27, January 16 PSA .86, March 18 PSA .46), but it is not declining as fast as during the second cycle. (By the way, my PSA decrease under Lupron is slower than most men experience, almost surely because my case was and is more challenging - more cancer to deal with.)

The goal is to get the PSA down to at least under 0.05, and ideally to less than 0.01. Of course, you need an ultrasensitive test that is capable of reliably measuring that low. The one I like is the first one approved, the Immulite 3rd Generation ultrasensitive PSA test made by Diagnostics Products Corporation. My PSA has declined to less than 0.01 on each of the two previous cycles of Lupron (and Casodex, Finasteride, and Fosamax or Boniva). Some doctors do not understand the importance of this goal. [/COLOR]

... According to the lab that did the test it should be between 241 & 827.

[COLOR="darkgreen"]That reference range is the normal range for men; it is not the range for men on hormonal blockade therapy.[/COLOR]

I have no sex drive at all but I think it is better to have low testosterone then it is high to keep the cancer in check.

[COLOR="darkgreen"]Amen to that! There are things we can do to increase sex drive somewhat while on hormonal blockade, but most of us are pretty happy while on the Lupron/Zoladex class of drugs, despite the low drive, provided our wives don't mind.

If you can get that PSA to less than 0.05, or especially if it falls to less than 0.01, you might want to consider intermittent therapy - giving yourself a vacation from the Zoladex. If you haven't been on the drug too long by that time, your testosterone should recover and you yourself should get pretty much back to normal. "Too long" varies, and it gets shorter as men get older, but I've heard that a man of 70 can stay on blockade about two years and still have a very good shot at getting his testosterone back after he stops the drug.

One of the reasons I'm a fan of triple blockade is that it seems to do a better job of controlling the cancer, and there's solid evidence that it results in much longer vacations for those on intermittent therapy. I can post about that if you would like to know more.[/COLOR]

Thanks Rich[/QUOTE]

[COLOR="darkgreen"]Your'e welcome. I hope this helps.

Take care, :wave:

Jim[/COLOR]





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