Testesteton levels and PSA relationship.

[Ralph1966]

Hi,

My story: PCa G 9 (4+5) at age 51 and PSA at time of surgety was 12.0 ng/ml, went through RRP surgery Sep 2017 then BCR January 2019.

SRT of prostat bed with 6 months of Firmagons, last injection October 2019.

The T level went to < 10 ng and PSA < 0.008 ng. T level yesterday 06/11/2020 was 91 ng PSA is still < 0.008 ng.

My MO said we will know the effectiveness of the above combination therapy when Testesorone level increase and PSA remain undetectable.

I know that with G score of 9 recurrence rates are high, but at what levels of Testestetone one should expect a recurrence is it 100, 200 or full normal levels? I mean when the dormant PCA cells will (smell) Testestetone and get reactivated?

Also should I repeat PET scan with undetectable PSA?

Last Auxumin PET scan March 2019 didn't show any metastasis.

Appreciate your sharing of personal experience.

Thank you all my friends.

Ralph

[addicted2cycling]

My info -- 2015 almost 65yo with GL10 and PSA14+, chose immediate castration via bilateral Orchiectomy, a Hemi Cryoablation of right side GL10, lesser left side Focal-Cryo + immunotherapy injection AND 1 MONTH LATER BEGAN Testosterone injections (contrary to medical protocols)

3 years later 2018 PSA rose to 3+ had Axumin showing return left side GL6 and GL7 spots and again Cryo. This January PSA was trending up, another Axumin results clear then another rise with 3TmpMRI result clear. In my case PSA and NOT Testosterone level is used as marker for testing.

For myself being a Unique Eunuch the testosterone level is not used as a determining factor for testing/scanning since following shot it is 1600ng/dL and 2 weeks later 400/600ng/dL.

NOTE -- YMMV and since with my situation being contrary to accepted norms so just giving a different perspective. Desire is to maintain a high QoL (Quality of Life) that requires 100+ mile a day bicycle rides 2 to 3 times per week not being an issue.

[Ralph1966 in reply to addicted2cycling]

Thank you for sharing your experience.

[Hidden in reply to Ralph1966]

I have reported regarding my very high correlation of PSA with 3glycerides after RP, here:

healthunlocked.com/prostate...

I have also noticed an equally high correlation of PSA with DHT, but am not so confident about it as I have fewer DHT tests.

From the number of tests already taken, it becomes more than evident that the total testosterone count is inferior vs DHT (dehydrotestosterone) as PSA progression marker.

Simplicity rules of thumb arguing that DHT is approx 7% of total T, so no need to test DHT - total T suffices, prove all wrong in my case. After 4 labs, this percentage in my case ranges from 3.18% to 8.99%, an almost 3-fold ratio.

Currently, I am trying any known way to lower 3glycerides and DHT to see if PSA will follow. My next blood test will be after 2 weeks.

[Ralph1966 in reply to Hidden]

Thank you for sharing your story.

[pjoshea13 in reply to Hidden]

You are in sync with Dr. Myers on DHT. He prescribed Avodart for elevated DHT, but said nothing in his vlog about DHT made in PCa cells. My attitude is that that taking Avodart is a safety play.

Triglicerides are a substantial issue IMO. I try for ~50, but when castrate it goes up to ~100. Excess carbs end up as triglycerides. The Sears-Zone rule of keeping to his carb-fat-protein ratio for all meals & snacks helps. An easier rule is never to eat carb without fat. Slows down the release of glucose into the blood. It's the excess glucose that turns to triglycerides & gets stored preferentially around organs.

Good luck!

-Patrick

[LearnAll in reply to pjoshea13]

Best statement: "Excess Carbs end up as triglycerides" Rule of 1/3 rd...food calories should come 1/3 from each Carb, proteins and fats.

1 gram of fat has 9 calories, one gram carb has 4 calories and one gram protein also has 4 calories.

Simplest way to melt your triglycerides is to walk miles each day. I walk 5 miles a day and my triglycerides are 68.

[LearnAll]

Testosterone recovery leads to increase in PSA. The more important thing is velocity of PSA increase.

The crucial data is when T has reached 50 ng and when T has reached to your pre ADT level.

The speed and extent of PSA rise at these 2 points give us aggressive level of your PCa.

There is no fixed level of T when PSA rises...it varies from one man to another.

The best prognostic sign is that your T has recovered to full pre treatment level BUT your

PSA has not started moving up. But this happens only in some lucky people.

[Ralph1966 in reply to LearnAll]

Thanks, my preADT level was 290 ng for Testesteton and PSA 0.17 preior to SRT.

[Fairwind]

It's just a waiting game now...Your PSA may stay in the undetectable range (as it is now) forever or at some point it may it may become active again..When will this happen is impossible to predict..

[Ralph1966 in reply to Fairwind]

Thank you Fairwind for your feedback, appriciate it.

[Tall_Allen]

IF there is still cancer, it won't get reactivated markedly until T increases over 120 ng/dl. There is no point in getting a PET scan while your PSA is so low.

[Ralph1966 in reply to Tall_Allen]

Thank you TA. Also my other question is: checking PSA every 3 month is the right thing to do for someone in my conditiin? Or I should check my PSA monthly at this point?

[Tall_Allen in reply to Ralph1966]

Every 3 months is fine. Your T is rising slowly and your PSA is great, so there is no advantage in closer monitoring.

[cancerking]

I am similar to you, surgery, radiation, Lupron for six months. Prior to radiation PSA 0.006, same number following radiation and three months later. In two weeks I will have my blood test again. As the testosterone comes up, if the PSA stays stable good deal. I am hoping for an increase in testosterone and a PSA that plateaus. Testing every three months is fine.

[Ralph1966 in reply to cancerking]

Thank you for your feedback and good luck with your coming test.