Dr. Strum - ADT - IADT - PCa and Test... - Advanced Prostate...

Advanced Prostate Cancer
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Dr. Strum - ADT - IADT - PCa and Testosterone


It seems from reading this paper the longer it takes T to recover during the off cycle of IADT, the longer the time to PSA progression. If that conclusion is right then it might be a mistake to initiate TRT during the off cycle.



6 Replies

Well, it seems like common sense that a prolonged period of low T levels would correspond with a longer time to PSA progression because it doesn't matter to the cancer cells "what" is keeping the T levels low (being on ADT, or the slow recovery of T during IADT), the hormone sensitive cancer cells are still going to be dying. Sorry, but not sure I understand the acronym of TRT.

Hidden in reply to Hidden

testosterone replacement therapy= TRT


"reaching a testosterone level ≥150 ng/dl in ≥4 months off ADT"

is an independent factor - not a requirement.

A man who needs 4 months to reach a T of 150 ng/d/L, is going to remain hypogonadal. In essence, such men continue to be castrate for a significant part of the off-phase.

I would define the off-phase as beginning when T reaches some number between 150 & 200.

Dr Freedland has said that for many men, the off-phase is a continuation of ADT.



I was on IADT for the first five+ years and now coming up on seven years it's full time. Whether my T increased or not during 'vacation', I still felt the same. Time off meant nothing.

Joeym1040 in reply to Hidden

Same here


My experience was very different. During 7 months of IADT, my T levels rose to over 760 and all side effects of ADT were reversed. Unfortunately, my PSA levels rose quite a bit, so I had to go back on therapy. I guess it all depends on how well your T levels recover and there is no way to know that ahead of time.

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