Falling PSA but rising Testosterone

[Avanat]

My husband, Steve (Stevana on this site), has had his PSA and testosterone checked every 3 weeks during his chemo and immunotherapy treatments. Ever since he started on Firmagon his PSA has gone down and as of December 23rd it is .08. His testosterone has been undetectable (<3.0) for the past six months until November when it jumped to 12. On December 3rd it was 15 and on the 23rd it was 16. His oncologist didn’t seem too concerned however we haven’t spoken to him yet after the last results. Has this happened to any of you and if so, what are the implications? The fact he’s been on Firmagon and yet T is rising is concerning to us. The good news is his PSA is still falling. Thanks for any insight you can give us.

[Mascouche]

I am not familiar with Firmagon itself but not all ADT drugs lower testosterone. For example, Lupron lowers it but drugs like Bicalutamide can actually increase your testosterone but they act by blocking the receptors in your cells so that they cannot use the testosterone and as such they achieve a similar thing.

Wishing you and your husband the best of luck.

[Tall_Allen]

Any T below 20 excellent.

[dhccpa]

Yes my PSA had been 0.7-0.9, back and forth, from 11/2018 to 5/2020. Then it rose to 1.3 in May and 1.4 in June before falling back to 0.8 in August and September and 0.7 in October and early December. Testosterone had been below 10 since 11/2018 but recently rose to 15. Not sure what it all means, if anything. I've been on only Lupron since 11/2018.

[doc1947g in reply to dhccpa]

What units are they using fot your Testosterone tests?

As you can see, there are many units so it is hard to comparate.

On this site, you cans see all the units:

unitslab.com/node/136

[dhccpa in reply to doc1947g]

I don't know and don't have my blood test report handy at the moment. They have all been done at Quest Labs, same location over a 2-year period.

[doc1947g in reply to dhccpa]

Historically, a serum testosterone below 50 ng/dL was considered to be the castrate level.

Current data suggest that the new target for either surgical or chemical castration is a serum testosterone level of lower than 20 ng/dL in an attempt to maximize therapeutic outcomes.

So mine is <5.7684 ng/dL.

[dhccpa in reply to doc1947g]

I don't understand what you mean by maximizing therapeutic outcomes.

[doc1947g in reply to dhccpa]

There are a few therapies to treat the PCa and with a low testosterone, these therapies work better, they give the maximum results.

[dhccpa in reply to doc1947g]

Thanks i understand now. Sometimes i read so many posts i begin to fade away.

[doc1947g]

I have been on Lupron Depot 22.5mg/12weeks X2 from May 2020 to Nov 2020 and on

VMAT-RT 3Gy X 20Fx in June 2020 and my

PSA = 0.03µg/L and my

Testosterone = <0.2nmol/L or <0.0577µg/L or <57.684ng/L or <5.7684 ng/dL

Had a test on Dec 15th 2020 and waiting for the results.

[doc1947g in reply to doc1947g]

Got my results.PSA 0.01 and

Testosterone = 03nmol/L or0.86526µg/L or <86.526ng/L or <8.6526ng/dL

So PSA new nadir from 0.03 and

increase from <0.2nmol/L or <0.0577µg/L or <57.684ng/L or <5.7684 ng/dL

am very happy because my 2 cancers are dormant.