Low Testosterone Level

[BobGee]

I'm stage 4 close to 5 years since devinci removal, lupron, casodex and xgeva, PSA under 0.02.

Question - my testosterone level is "3" which sounds good but I can't get a response I understand on its relationship with PSA, etc. Can someone kindly explain the significance and hopefully good news on low testosterone with my condition. Thanks !

[Tjc1]

Hi Bob, the lower the testosterone level the better. 20 is considered castrate. So the less testosterone the less food for any cancer cells remaining. May someone here can go into greater depth than me. Good luck Bob!

Thomas

[Dr_WHO]

It is great news! The goal of the ADT therapy is to reduce the Testosterone. Prostate cancer feeds on testosterone. The goal is to starve (unfortunately not kill) the cancer. Normal testosterone is between 400 to 900. Anything lower than 20 and you are a monk. A testosterone level of 3 means that you are starving the cancer more than if you were on slim fast!

Good work!

[Litlerny]

Good for you, Bob! It’s very good news. You are right where you want to be. Keep the PSA undetectable and the testosterone in single digits and you can extend your 5 years a LOT longer. Have a blessed day.

[petercraig2]

I find this whole PSA and Testosterone discussion very interesting.

In 2000 I had PSA of .54 and apparently normal. In 2016 my stated ti increase and PSA peaked at to 24.3 and then following DaVinci surgery PSA was 3.3. Subsequently it then escalated to 8.9 and T was 13.9. I then started Estrogen patches in July 2017 and now PSA is .17 and T is <.1 and has been that low for 4 months now.

PSA is still going down which I 'm happy with but PC really shouldn't have anything at all to sustain it and I can't figure why there is any PSA value at all?

Any thoughts on this conundrum

Peter

[BobGee in reply to petercraig2]

PeterC2 - I can relate to your confusion, prompting my initial inquiry here. I seem to get from a variety of oncologists conflicting statements on the whole PSA-Testosterone relationship and remain confused despite the informed reply comments presented here.

(e.g. "Most older men have prostate cancer in them, but those with high testosterone levels, maybe even from supplements, don't necessarily have increased PSA which signals prostate cancer and yet once stage 4 prostate cancer is diagnosed via high PSA et al, the aim via ADT, etc. is to reduce testosterone levels which feed prostate cancer ." Huh ?)

Fortunately, I seem to be on the right side of this, so I ain't complaining, just confused.

[dave100]

It is my understanding that Testosterone isn't a food or fuel for PCa growth but rather a stimulation factor that serves to activate cell growth and division. With that in mind, it stands to reason that keeping T to as low a level as possible helps slow down the progress of the cancer. At some point, the cells develop ways around the low T environment by perhaps generating more and more "receptors" that "collect" testosterone molecules or even synthesizing alternative stimulants to self-activate themselves. We measure PSA levels (because it is specific to prostate cells) and consider it an analog for growth of the Pca cell population because these renegade prostate cells generate the PSA protein as they grow. Thus, the goal for us is to keep T low and hope that the PSA stays low for as long as possible.