Thinking about taking a holiday from ADT this summer. How long does it usually take for testosterone to come back? Thanks.
When does T come back?: Thinking about... - Advanced Prostate...
When does T come back?
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gcman
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I am reading a lot of studies about Intermittent ADT. I stopped Luprolide on dec04,19. MY PSA remains at0.3 and T remains less than 10 after 2 weeks.
Plan to watch PSA, T and ALP evry 2 weeks.
T comes back at different times in different people but most people regain their T in 4 to 6
months. Regaining T brings back good QOL. But needs to watch PSA as T likes to pull up PSA.
I’m 4 months on ADT holiday. Still having regular hot flashes (t still low). Will have new bloodwork done on the 28th and will post here.
Not to be discouraging, but I completed 3 years of ADT in February 2012. My T never came back. Last test (10/19) T = 50 ng/dl. Hot flashes have finally diminished to relative minor night sweats 2-3 per week. On the other hand, my PSA remains undetectable after radiation and ADT for a Gleason 8, T4 tumor at age 62. So I'm not complaining about diminished QOL when I still have L 11 years later.
90% recovery takes about 1 year from what I've read (not sure from what point that starts). The recovery value may be lower than the before-ADT values depending on how long someone is on ADT.
LearnAll in reply to
During first OFF cycle, the T recovery is usually longer. Subsequent cycles ,T recovery gets shorterrand less high.
The length of first OFF cycle gives an idea about hormone resistant ...if it is longer ,the person has hormone resistance far away...shorter first OFF cycle leads to faster hormone resistance state.
There are many studies which say that Intermittent ADT makes hormone sensitive state longer. A chinese study clearly states prolongation of hormone sensitive state in Intermittent ADT. Lawrence Klotz study also mentions this. Also, The FinnProstate study says that Intermittent ADT is non inferior to Continuous ADT in OS, Progression and CSS. Cardiac deaths were higher in Continuous ADT compared to Intermittent ADT. Fracture rates were also higher in Continuous ADT.
However, if PCa is very aggressive type, one needs to stay on Continuous . Poor candidates for Intermittent ADT are (1) with fast PSA doubling time, (2) Nadir PSA higher than 1, (3)Nadir T higher than 20, (4) One with Visceral mets. (5) multiple comorbid medical conditions.
NOTE: Initial High PSA level is not a bar to do intermittent ADT as long as Nadir PSA is very low (less than 1) in case where prostate is intact.
LA, what is a longer off cycle, time wise, versus a shorter off cycle?
It means when you are OFF Adt..the T remains low for longer periodof time.
On cycle is when you are ON the ADT .
So it’s the time it takes T to recover, not the time for PSA to increase to some predetermined level that defines the length of the “ off” cycle?
RightTime to PSA to come up at set point varies..in some people it can take even years before there is upward PSA movement is seen. Those are the lucky people.
Right but, based on what you stated about time to T resistant stage your also a lucky people if it takes T a long time to recover? So, just trying to quantify here, how long is a T recovery period that is indicative of a long time to the resistant phase.
Lets get a very basic fact clear first....That is...If you anihilate T totally and then,keep it suppressed continuously strongly....the cancer cells get very desperate to survive and they find other ways to stay alive and grow. That is what we call Androgen Resistance.
So when ADT is inturrupted T starts to creep up slowly . The cancer cells are now relaxed as they see T is available. And that incentivize them to stay Androgen sensitive. I am simlifying what Dr Lawrence Klotz has described in his research.
So ..by Intermittently...letting T rise again keeps Androgen sensitivity for a longer duration.
Everyone is different. It depends somewhat on how long you've been on ADT. Here's how long it took for guys who were on ADT for 9 months. After ADT cessation, testosterone recovered to normal level in 37%, 66%, 86%,and 93% of patients after 3, 6, 9 and 12 months, respectively.
ncbi.nlm.nih.gov/pmc/articl...
That's good news. Doc told me guys starting with high T it comes back faster.
From what I’ve read, 6 to 18 months!
From what I’ve lived... about 9 months.
My last 3mo Eligard shot was in Nov2018, and my T made it to 103 in Nov 2019. Barely above castration of 50 but on the good side anyway! As of this date, my T is 300 and mostly all of my SE (and my list could choke a horse) are gone except for the severe cognitive issues.
Watching my PSA that was >0.1 through out my ADT and was 0.1 when T rose above castration in Nov 19. It is now 0.2 as my T enters the normal range!! Watching, waiting, watching, waiting...... with the PSA goal posts set at 2.0!
Savoring E V E R Y.... F U C K I N G... M I N U I T E of my vacation!!!!
Other observations;
Penile rehab appears to be working but not good enough for penetration yet!! Nice to have a package again though!!
I’ve got my libido back but lacking the tools to work with (subtle reminder of ADT).
No mood swings, hot flashes, no crying, no uncontrolled laughing, etc!!! Likely forgetting a bunch but there’s that brain thing!!!!!
Jc
You have great numbers but do you have distant mets? If so then your numbers have some relevance for this community who have incurable stage 4 metastatic PCa.
Hope you get a boner you can hang a fence post gate on.....and i too would savor evry fn second....to lo psa and a long vacation...bw
My husband discontinued Zytiga and 3-month Trelstar injection in May 2018 after being on them for 1 year. His testosterone was undetectable while on the meds. The Trelstar was 3 months through Aug. In Sep, T was 20 and in Oct it was 361, by May it was 621. He was 61 at that time and has been athletic his whole life, but he was no longer exercising as the ADT caused him extreme exhaustion. Recovery was 2 months to get into a normal range, which, admittedly, is on the quicker side. Full recovery to his pre-castrate levels took 9 months.
Factors leading to faster and full recovery of T after stopping ADT:
(1) Age les than 65.
(2)Total duration of ADT : lessthan 18 months
(3) Intial T level higher (more than 400)
(4)Higher SHB globulin level.
Someone who has been on ADT continuously for many years...sadly ..gets his semen producing machinary permanently damaged. The Leydig cells of testicles and other important cells shrink and can not restart producing fluids and T.
Intermittent ADT keeps the apparatus in working order...like lube in the parked car !
in reply to LearnAll
One of the first doctors I had said "Have you heard of ADT vacation?" I said yes. Then he said, "Not for you." I can imagine some people would have been really pissed off over that, but I just laughed. Many of us here are stuck with it for life so just have to roll with punches.
LearnAll in reply to
I have appt with my MO on April01 .I know she will be not thrilled about my decision of trying Intermittent ADT. I have about a dozen reaserch studies printed along with a list of my postive prognostic features to convince us to give me chance to try Intermittent. Also, list of my dietary and herbal interventions to show her.
The best thing about PCa is that we can monitor state of our cancer closely by biomarkers such as PSA, ALP. Hb, Albumin, LDH , NLR, PLR ,CRP etc.
Any time we see negative direction of these biomarkers we can easily go back on Leuprolide Inj. immediately. (This is true for people who had high PSA producing cancer cells and responded dramatically to ADT)
Why did your MO outright rejected the idea od Intermittent ADT ?
I began ADT in April 2010, for 2 years, as primary treatment combined with EBRT
in late 2010.
By late 2012, Psa was 0.08, and to see if the treatment had worked, I stopped ADT and Testosterone increased from < 0.5 to 20 in 6 months, and I felt like new again, but had to go right back onto ADT because Psa went up to 8.8, so initial treatment failed.
But I noticed the increase in strength and stamina and sexual ability coming back after about 3 months after missing the date for 3 monthly Eligard injects. In other words, each Eligard inject lasted longer than 3 months, and they could be maybe 5 months apart instead of 3 months, and Testosterone rise would not be noticed.
I had one more pause in ADT in 2015, and same thing happened, Psa went up fast, but T hardly rose, and at that time it signalled the destruction of testicular ability to make testosterone, and all sexuality abilities were gone, and remained gone. In 2016, I was changed to monthly Lucrin injects, and and that failed later in 2016, I had Cosadex added, then that failed in 6 months, then Zytiga added which failed in 8 months. I'm still on Lucrin, just to be sure, but if I quit the Lucrin now I doubt any rise in Testosterone would ever occur - my balls are stuffed.
I'm now 72, I cycled 56km today at 23.5kph average speed despite all treatments, and its been years since anyone my age has overtaken me on the bike, so I am doing OK as a castrated old man.
Patrick Turner.
Got the 6months Lupron shot 5/19, Still <10 T 10months later 3/20, Told by MO that T should return by this coming May, so 6month shot got me 12 mo suppression. (hopefully)
Mine never did after Firmagon
9 mos of Lupron. Return of T should have begun in Aug 2019. Since then T rose from <10 to 70 (Woo-hoo) over that time. Doc said it may be another 3-6 mos before "full" return. Edinbaltimore
My 19 month ADT ran out on Jan. 7, 2019, as of today (14 months later), nothing has come back sexually, nothing. Still hot flashes too. Age 78.
Bob, G9
In more than 80%, T comes back in 4 - 6 months. The problem is that the SEs go away unevenly. For me, I started to feel like a human being again in about 3 months, but I was still having hot flashes at 11 months.
After a six month eligard shot I think it was about 2 months after the nominal end of that six month period. The urologist was surprised at the quick T recovery and asked if I was taking T supplementation or injections. Nope.
My 6 months of Lupron therapy ended May 2019. My T has risen since then, but I don’t recall the number. I’m still having hot flashes, but not nearly as debilitating as they were. I have seen some libido return, and some ability. But as I’ve said before, I have 2 major barriers to sex these days: 1) the whole prostate cancer thing, and 2) my wife. 😜
Took me 3 months before becoming detectable (22), Three months later it was 515, then back to ADT 
T at 850 in 2004, six years of ADT. Hopefully that T would cone back. At eleven months, my research medical oncologist tried to jump stat it with Androgel. Did not work to re-start. A year later started 4 mg of Androgel twice a week. That was in 2012. I still use supplemental Androgel in low doses. My T ranges from 750 to 350 depending when I used the gel. Supplemental T has a short half life.
GD
Boywonder56 in reply to
And psa.....still hiding?
in reply to Boywonder56
Yep. <0.1. I am most fortunate.
So I've been on them since 2012 and just got off of them for Chemo in January 2020. That's 8 years on. I already, during Chemo, feel more energy than I've had in the last 5 years. That is a no doubter already.
I'm not saying I'm a musk smelling, snapping a Captain Morgan pose off, testosterone loaded guy. Naw, still don't have much drive.
And yet, I have hope of the hair that came with puberty returning, sweat that stinks, and impure thoughts about my wife.
Peace,
Bees
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