Testosterone rising consistently

[Jessie5]

Hello Warriors,

My husband Mike has been on Lupron since May 2020 (every three months).

After three months on Lupron (Aug 2020) his PSA was .06 (awesome), T was 15 - lowest it ever was and started rising after that.

Nov 2020 it was 16 (PSA .02)

And most recently on this past Monday T was 19 (PSA still .02).

I am concerned with the consistent rising of T. It is not bouncing or fluctuating just keeps going up every 3 months. Majority of Studies I've read state Testosterone should be below 20 - for now it is only 19 but I'm concerned if it rises above 20 and continues with the upward trend.

He was already stage 4 (area in bladder, several lymph nodes and an area in sacrum) when he had RP 12/2019. Three months after RP first PSA was 1.44 and less than 2 month doubling time. At Start of HT May 2020 PSA was 2.9, he completed 38 rounds of radiation Sept 2020. He does have ATM mutation. He is 51yo now.

What are your thoughts of T never going below 15 and consistently rising over the last 9 months? I hope I'm overthinking it. Much love to you all.

[Tall_Allen]

It is fine. PSA is apparently being controlled by the low T, and presumably the cancer is as well. There are non-testicular sources of T and other androgens. That's why Zytiga is so effective.

[tango65]

It is considered that a patient has castration levels of testosterone when the testosterone is lower than 50. Most MO will prefer to have the testosterone at 20 or below . Do not worry unless the testosterone goes over 20 and continues to increase.

[Hidden]

It used to be that the white coats wanted a mans T score under 50. Now days they like to see it lower than 20. The link tells the story. ncbi.nlm.nih.gov/pmc/articl...

[GP24]

It T keeps on rising I would switch to Relugolix / Orgovyx pills. This is apparently more potent than Lupron and will reduce T again.

[dhccpa in reply to GP24]

I'll have decision to make in June when Lupron shot wears off. You're saying the new pill is better than Lupron? Not merely similar but in pill form? I've debated whether I want to add a daily pill or just get six month shots. I have been very stable on Lupron for over 2 years with very minimal side effects. Thanks

[GP24 in reply to dhccpa]

It is a bit better: "Relugolix achieved superiority over leuprolide in sustained castration rates, castration and profound castration by day 15, and PSA response by day 15. "

urotoday.com/transformative...

[Hidden in reply to GP24]

I think the gentleman is already at castrate level so the 15 day to castrate level is not relevant anymore.

[GP24 in reply to GP24]

"...sustained castration rates..." is relevant, I did not shorten the citation.

[dhccpa in reply to GP24]

Thanks, I'll read that. I would say there's a 50/50 chance that when I next see my oncologist in late June, he will say that his institution still believes Lupron is the way to go, but this'll be a good test.

[Magnus1964]

I would say it's time to move on to a new ADT drug, casodex, zytiga, xtandi etc.

[V10fanatic]

I've been on Lupron and Zytiga for 9 months now and have seen my monthly T fluctuate as follows:

9.5 25.7 56.8 33.2 24.0 11.7 18.9 14.1 17.1 28.1 (latest)

Even though my PSA is undetectable, I'm a bit anxious that T on the rise yet again.

[Doseydoe]

Hi Jessie, hang in there, 51 is so young but it's good you guys found it when you did. Keep an eye on what's going on in the bladder. I trust the radio was directed there as well as you must not leave it unchecked. All the best 😎DD.