Testosterone Recovery in Patients With Prostate Cancer Treated With Radiotherapy Plus ADT

[SierraSix]

urotoday.com/video-lectures...

Tanya Dorff and Alicia Morgans discuss testosterone suppression and recovery in prostate cancer patients. They review data presented by Dr. Nabid, an analysis looking at a large set of patients treated on two different clinical trials of radiation therapy plus different durations of androgen deprivation. With six months of androgen deprivation therapy (ADT), 75% of men recovered normal testosterone levels, but the median time to recovery was 18 months. With 18 months of ADT, only a quarter of men recovered to normal levels, and the average time was five years. Dr. Dorff emphasizes the importance of discussing this data when talking to our patients about side effects of ADT, how long they may last, and will they recover their testosterone, and if so, when?

[PSAed]

Thanks for posting this information

[VCinTx]

After RT and 18 months of ADT, I chose to start TRT. I haven't had a significant rise in my PSA.

[Ramp7]

I've been on Lupron for about 3 years. It stopped working after 16 months. I was kept on it during Trial Study at Dana Farber. Moved onto BAT self administered with guidance from various MO's. Still taking 3 month shots. My testosterone may never recover on its own I figure.

[London441]

I was on ADT for 18 months and recovered to a baseline T of 650 within 6 months. Men should know their baseline to establish reasonable expectations. Those with low baseline T cannot expect too much and may wish to try carefully monitored TRT, understanding its risks.

Physical condition and biological age play an important role. Higher levels of fitness and strength assist T recovery greatly, as they do with everything else.

[OldVTGuy]

I am leaning toward ending ADT at 12 months. I understand that if your only concern is maximizing the chance of cure you go longer, but clearly there are real trade offs for that additional X% of improvement. Two which stand out are 1. the damage you are doing to the rest of your body while you deprive it of testosterone and 2. the increased likelihood your testosterone will never recover the longer to suppress it.

I am thankful I have an RO that understands this and welcomes putting all cards on the table for discussion.