Advanced Prostate Cancer
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Casodex and Mystery of Testosterone

Casodex increases testoserone while decreasing PSA. However, since I am on Casodex 150mg/day monotherapy, beginning in October 2015; my testosterone scores NG/DL are:

1/22/16 - 505

5/16/16 - 717

8/12/16 - 703

10/13/16 - 542

3/28/17 - 493

My PSA NG/ML levels were:

8/12/16 - 7.8

10/13/16 - 6.7

2/16/17 - 13.6

3/28/17 - 23.0

(Testosterone was not taken on 2/16/17.)

(Blood draws were all done in the morning)

Summary: Testosterone increased from 505 to 717 then 703, but decreased to 542 and 493; why did it decrease?

**Why did testosterone decrease while on casodex?**

P.S. I will have Firmagon monthly injections for three months; then Lupron monthly injections for three months, then I will re-evaluate. I will stay on Casodex for combined hormone blockage. In addition, I will add daily Metaformin and my supplements (Lycopene, Zflamend, Zinc, and Magnesium). Also, I am scheduled for both a CAT scan and bone scan this month.

Thank you. Rich.

7 Replies


your T decreased because the AR mutated and now using Casodex for fuel...same reason PSA increased

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Doctor said stay on Casodex and add Firmagon. Your comment?



I don't know why your testosterone level went up. It is known that T levels can vary quite a lot in the same person at different times of the day and for unknown reasons.

Adding Firmagon sounds like an excellent idea. It looks like your Casodex monotherapy isn't holding down the cancer any more. I'm not sure the Casodex would be needed once the Firmagon starts. I'd ask your oncologist about that and, if he thinks it's still a good idea, should the dose be reduced. I'm not an expert and could be wrong, but I thought that Casodex is given at 150 mg/day for monotherapy, but only 50 mg/day when used with another drug to reduce testosterone production.


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"I don't know why your testosterone level went up." I know why it went up. I want to know why it decreased! I was going to mention a reduction of Casodex to 50mg. when on Firmagon, then after 3 months discontinue Firmagon; then go on to Lupron.




Casodex does not decrease testosterone.

Thank you for your reply.



I'm also on this therapy with avodart. Also will follow up with lupron or firmigon because may not be blocking all that testosterone with casodex so will try another antiandrgen nilutamide flutamide or extandi (ensulitamidel). Dr Barken said most got 2 or more years on this follow up would be interested in your results. Hope this helped a little.

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On this protocol I got 1.25 years before some of the cancer cells found a work around of Casodex.


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