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Advanced Prostate Cancer
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Low Testosterone

Hi. My name is Lisa. My husband Bob was diagnosed with prostate cancer in 2016. He's had a total prostatectomy, 12 weeks of radiation and two lupron injections. We're both 63 years old. His Gleason score was 7. The cancer spilled out into his abdomen and there were cells found on the surgical margins. No lymph node involvement.

It's been a year since my husband's last Lupron injection. Not only is his testosterone still low, it's dropped to 187. Does anyone know if that's normal? Will it eventually go back to normal? Isn't a year a long time? Thanks!

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187 for testosterone is low. Was the Lupron shot a 3 month or 6 month shot? Also do you know what his T level was before going on Lupron?

Generally testosterone levels recover fully after 1 year. Here's an article on the subject: ncbi.nlm.nih.gov/pubmed/164...

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Two three month shots

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Thanks. Very helpful article!

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12 weeks of radiation? I've never heard that before - salvage radiation is usually about 7 weeks. His testosterone is low. When he has a record of undetectable PSAs his doctor may consider supplementing.

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Yeah, 12 would be a hell of a lot - I had 40 - about 8 weeks...plus, a major change is coming...hypofractionated radiation - it'll run about 2-3 weeks.

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Ooops. I meant 8 weeks. Sorry.

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Hi all,

I had 13 weeks after surgery to remove and then a recurring elevated PSA. It kept me clean for 2 years.

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Your husband may have had lowish testosterone [T] when diagnosed - perhaps because of an undiagnosed chronic low-level infection. T recovery after ADT is slow, but it's beginning to look as though he might not get above 350 ng/dL (the start of the normal range).

Some doctors are still reluctant to prescribe T for men who have been treated for PCa, but at age 63, I would be aggressively looking for a solution.

-Patrick

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Many Men who get the Pca disease--were already low T 340-350--and less. In my personal experience at an age going on 75. After stopping ADT, my T went from 20 to 450 in 6 months. BUT, the important number to feeling good and performance--is the FREE TESTOSTERONE. Almost nobody checks it. It should be at least 15% of the total number. Mine was about 8%, of the total--thus I know that most of my Total T was bound to the SHBG agent. So I needed to raise my Free T. To raise my Free T I used Avena Sativa, and Stinging Nettle, 2 supplements that release bound T from the SHBG.

On to your Husband--as I am not the subject---There is a possibility of Nature Identical Supplementation of T. Which can be prepared by Compound Pharmacies. But you should be under the care of an experienced MO who uses T Supplementation. They would probably prefer to use an injectable. This would be a serious decision. I would not attempt it unless I was taking Avodart.

Before doing anything---It might be wise to recheck your T and ask for a Free T test also at the same time. Bet it is about 10 ngs/dl. If total is 187 the Free should be about 25.

Finding a Solution as Patrick says at age 63 might be a fruitful adventure---remember your still a cancer patient!

Nalakrats

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I did not see PSA and Free PSA history. I can only relate to my Gleason 7 (4+3) in 2003. Seeds with 25 sessions of external radiation as a planned primary treatment. T at 800-1000 during this period.

PSA never really came down and started riding at nine months and at 11 months of primary treatment, PSA rose to 32.4 from the original 6.8. Scans when compared to the initial scan, seed scan and the external scan revealed two mets to my spine. I immediately took a three month Lupron injection and then planned by next course of action - so in 2004 and six weeks after finding mets, I underwent a six month chemotherapy trial.

I got to my Medical Oncologist on recommendation of my two Radiation Oncologists. My research medical oncologist wanted my T at less than 5! Less than 20 acceptable, but no more. I maintained less than 5 for the next six years. In February 2010 I took my last Lupron injection. 11 months later T had not come back and was about 5. Continuing with the trial, I was allowed to take low doses of testosterone (4 mg Androgen, twice a week). I still follow this regime and my T levels range from 350 to 750 depending on when I put on the gel and draw blood. Now, I have been most fortunate and my results are atypical, but then again my treatment for metastatic PCa was also atypical.

As I wish your husband the best in kicking this bastard, I have to ask, why the hurry to bring back T? Why only two injections and then stop? He is still not out of the woods yet during his two year ordeal. Based on your writing, he could still have mutated cells in his body-Let's hope not.

I suggest that he research and then discuss with his Radiation Oncologist or Medical Oncologist, the term "micro-metastates". In my research, there is a good chance that he will eventually develop metastatic disease if Radiation did not kill the cancers cells before they entered the lymphatic or vascular systems. I am 71 years of age. PSA is <0.1.

My comments are not to add worry to your lives, but rather deal with this disease in a realistic manner. We all have varying degrees of disease and what works fir one dies not necessarily work for others. There are too many variables and multiple treatment thoughts even among trained medical personnel. Ask yourself, am I going for delay or cure?

Take Care,

Gourd Dancer

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