Just coming up on my 6 month anniversary of radiation and my 2 months prior to radiation and 4 months post Lupron while on radiation. So I have been off Lupron for 2 months. I had my annual physical yesterday and my GP had ordered complete blood panel with thyroid and PSA. There were no issues with blood work and PSA was not detectable.
My 6 month follow up is scheduled with my MO and RO is January. My MO gave me my lab slip at 3 months. She wanted a complete blood analysis and PSA. My RO has not sent me any additional lab request for our Jan follow up visit. I know those two work very closely and share info and blood work. In fact they do coordinate exams times so I can do just one visit back to back.
My RO did blood work at 3 months and PSA was not at a detectable level and blood work was normal for just undergoing radiation. My GP did a DEXA and testosterone test as a baseline prior to commencing Radiation. My RO did a testosterone at my request prior to radiation and it was not detected after two months on Lupron..
My question is how often should I be getting a testosterone test and what is the rationale for this. What information does testosterone level add to the remission puzzle?
Thanks
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Mgtd
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Eventually your T level will hopefully rise back to your baseline level. It will be necessary to know both your PSA and your T level. If your PSA stays low even when your T comes back, your therapy was probably successful. But if your PSA rises above 2.0, that is called a "biochemical recurrence" which may call for further investigation. If your T never rises back to baseline, you might want to eventually have some TRT.
You leave out so much basis in order to maybe provide an educated answer to your question that would help understand where you're coming from and where you might be going. Just knowing you received radiation doesn't help much.
For example, your original diagnosis including pathology reports and PSA history, family history age, general health, etc. Was the radiation your primary therapy? Secondary? What was the therapy as well, radiation differs, type, amount, etc.
Testing, including blood work can help reveal certain things for sure. But blood in itself is not an end all to answers. PSA testing certainly can tell us if the PCa is active. And Testosterone testing can help diagnose what's going on as well in conjunction with ADT use (or not). It just all depends.
For instance, a patient progressing to StageIV and on sustained ADT would want to know the PSA "AND" T levels. This would show whether or not the disease has become castrate resistant. But for you, that's well advanced of where we can assume you are.
You received a short course of ADT along with radiation. Typically, it would take as long as you've been on ADT for your T to recover, but not always. Some never do, or to where they were before therapy. And ultimately, with just primary therapy applied, absent advanced diagnosis, the stringent and excessive testing of T isn't really necessary unless there are other reasons. PSA control is what's observed. If it's stable, that's good. After radiation, you'd need a few tests around the same number to establish you nadir. This helps, as if your gland is still there, in all probability it will still produce some PSA. Surgery patients have an advantage here as the PSA should be undetectable. After nadir is established, any movement is worth watching, and then the Doubling Time of the PSA will determine what happens next. If less than 6 months PSADT, then action would take place regardless of PSA level although most Oncologist like certain thresholds to be met (as noted above).
All in all, it might be difficult to hear, but you need to chill and let things play out a bit. Have a series of PSA tests be taken, establish an average/nadir and only worry when worrying is required. For now the most important thing is to focus on your recovery and life!
Cool one thanks for taking the time to respond. I was just trying to get a feel for if those two tests - PSA and T should be routinely done together. It seems my RO, MO and urologist in the past seem to me to be focused on PSA and not worried about T.
For some reason in the back of my mind I thought there was a relationship between those two - PSA and T. Definitely there is a relationship to SE of hormone therapy and the loss of T.
I experienced really minor SE while on hormone therapy for those 6 months and continue that trend while I wait the return of my T. I attribute that to exercise, diet and a medicine my RO prescribed after radiation. One of the potential side benefits of this medicine in women was that 30 percent of the women had reduced hot flashes and night sweats. So that may also have helped with my lack of SE.
To answer your specific questions. I was diagnosed with Gleason 7 (4+3) and no cancer outside of the prostate, via MRI and scans over the year from initial PSA of 4.8 to confirmed diagnosis and now 25 rounds of hopefully curative radiation to both prostate and pelvic area as a precaution to stop micro spread.
My PSA prior to radiation never rose. My PSA had been constant at 4.8 for about a year prior to radiation. Prior to that my yearly PSA tests ranged from 2.5 to 3.5. At my age of 78 that was not a real concern until it hit 4.8 and an abnormal physical exam of the prostrate.
Hope that helps you answer the question should the PSA and T tests be normally done concurrently each 3 months for the next three years
I apologize for my lack of specifics in my initial post. Just thought it was a rather simple question.
Presently doing quarterly PSA and T testing now after fulfillment of all treatments. So approaching 2 years after ADT and PSA undetectable and T at 720.
I used the pill form of Antagonist ADT (Orgovyx) for 18 months so we wanted to see how quickly the T returned. I was at about 10 during ADT and it went to 285 within 30 days of stopping ADT and 420 at 60 days and then hovered at 400-500 for about 12 months. The last quarterly reading was at 720 this October. My T was at 740 prior to my treatments beginning (Surgery, ADT and Radiation). I also subscribe to the use it or lose it approach
Everyone's outcome will be different. I was most interested in using the Antagonist version of ADT and avoiding the painful monthly shots that were prevalent at the time.
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If I do, or if I don't...
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