Is my Testosterone high?

[Dlanghorne]

Have been on ADT for 25 months. (Lupron 6 mon shots, Abiraterone, & prednisone)

Was switched to Eligard on Monday. Bloodwork Monday showed PSA undetectable and testosterone at 51 ng/dL.

Is the testosterone high for being on ADT??

[Hidden]

Yes. You haven't reached the weaker definition of castrate. You really need to be below 20 ng/dl to get the most out of these treatments. Are you getting your injections regularly every 6 months? Are you taking the zytiga and prednisone as prescribed? These are often the leading causes of failed treatments. If yes. Then you need to discuss this with your MO on why your not getting to castrate levels. Ideally < 20ng/dl.

[Dlanghorne in reply to Hidden]

Yes, I have been very good with all meds on schedule. Will see doc on Oct 6 and discuss

[Hidden in reply to Dlanghorne]

Excellent. No sense in battling ADT side effects if they are not doing what they are intended for.

[noahware]

It sounds like that would be considered T "breakthrough." That is when the hormonal therapy fails at some point to keep T at castrate levels. One study showed men (on Lupron, I believe) to have a 5% breakthrough rate for the 50 ng cutoff and a 25% breakthrough rate for the 20 ng cutoff.

In that study, it did not appear to impact survival, but obviously the lower the better. If Eligard fails to get you low enough, maybe consider a different agent, like Firmagon?

[Jac_J in reply to noahware]

Interesting.

Is T "breakthrough" really a thing or was the Eligard administered incorrectly?

I too, have rising T (about 25 ng/dl) while undergoing Docetaxel Chemo. Im doing cycle 4 next Tuesday. Im interested if my T is continuing to rise.

Anecdotal evidence seems to suggest it may, as my "ball sack" has been getting bigger over the last few weeks. Perhaps indicative of testicular activity?

[noahware in reply to Jac_J]

The "breakthrough" seems to be a real thing... not sure if your level is worrisome, but worth talking to the doc about it.

[Tall_Allen]

Yes. Your 6 month Lupron shot started wearing off before you got the Eligard.

[noahware in reply to Tall_Allen]

Shouldn't abi alone be enough to keep most men below 50?

[Tall_Allen in reply to noahware]

Maybe - there's only one small trial of abi monotherapy. IDK if it's enough on its own to prevent testosterone production by the testes in all patients.

[Dlanghorne in reply to Tall_Allen]

Makes sense ...I WAS about 2 weeks late on eligard. Delay due to relocation to our second home. Blood work about 15 min after Eligard shot so reflected the Lupron in March. Checked with Doc and he said will see with November's bloodwork. I get bloodwork monthly (my choice) to be on top if PSA comes back. I have Oncologist at both houses and they both think Provenge is correct with ANY PSA rise. PSA in same bloodwork was undetectable....YES!!!!

[GP24]

Usually ADT+Abiraterone will lower T below 5 ng/dL.

[Dlanghorne]

What does everyone think of Eligard vs Lupron shots??