Can Testosterone go down during ADT break?

[dac500]

Some one in a posting in Facebook mentioned that during ADT break his PSA is going up, but his testosterone is going down. Can this really happen?

In my case

First break 2/26/20 to 8/28/20

6 month point T=114, PSA: 0.14

9 month point T = 147, PSA: 0.45

Second break 6/2/21 -

6 month point T=28, PSA: 0.19

9 month point T = 72, PSA: 0.51

Recently, my hot flashes have become more severe nearly 1 year into the break. My Gynecomastia has become more pronounced, painful to touch. Is it possible that my testosterone has either leveled off at 70, or even going down?

On June 1, I am going for blood works, annual X-ray, CT scan, and bone scan. I expect my PSA to reach 1.5 and I don't know what my testosterone would do.

[Hidden]

I never heard of T going down after ADT. Maybe ADT didn't get his T very low to begin with?

Have you tried a low-dose estrogen patch or a SERM (tamoxifen)? If not, ask your MO.

I don't have any hot flashes and always add estrogen. I have bone growth (per DEXA scans). My libido goes down but makes an appearance maybe once a week. I don't have any depression. I made the mistake once of not replacing estrogen. In a week or so my mind was in a very dark place.

[GeorgesCalvez]

I would say that your testosterone is very low compared with the normal level.

I would guess that your prostate cancer cells are partly testosterone independent, so can grow at very low levels of the hormone.

So they are chunking along regardless, in the meanwhile you are experiencing the side effects of low testosterone.

I would take PSA results with a pinch of salt, they can vary widely from day to day, testosterone also varies, so I would take the results as broadly indicative of the range.

That is my five to fifteen cents worth, mean value ten cents!

[dac500 in reply to GeorgesCalvez]

PSA can very somewhat from day to day, but the trend is, in most cases, indicative of disease progression. In my case this pattern is very much obvious. During active ADT, the PSA drops following a definite pattern. And during ADT break it rises following a definite pattern. In my blood works on June 1, I expect my PSA will be around 1.5 (rising from 0.51 on March 2). If it is significantly different, I would be very surprised.