Concern - At 4 mo on Lupron/Abi, Testosterone hits 40

[jackwfrench]

While PSA was again <.1 yesterday, testosterone jumped to 40 ng/dl or 1.4 nmole/L, which is a big move toward the 1.7 danger zone for faster movement toward CRPC ( ncbi.nlm.nih.gov/pmc/articl... ) , and I am interested in any observations. Last testo test was taken 3 mo ago and was <1. My MO doesnt have much to say about it and assumed I had stopped my abi, but I have not. Should I be concerned about an accelerated path to CRPC from HSPC, and if so what action might I consider? Thx

[Tall_Allen]

You misunderstood that reference and what CRPC is. CRPC occurs when PSA rises in spite of castration levels of testosterone. The failure of your ADT to achieve castration levels means that your ADT is inadequate. Maybe discuss switching to Orgovyx.

[Heykm01]

I had the same concern as you when I started down this journey. My T took about 6 months to fully drop, and bounced around a bit. I found the same reference (and more of them) - and the same concern.

I'd note that all of those studies / papers were prior to the standard use of 2nd gen antiandrogens.

I think the more important marker is PSA response - and yours is great!

With you being recurrent and low-volume you should see a good long response to the therapy you're on.

[maley2711 in reply to Heykm01]

My understanding is that 2nd gen ADT agents somehow involved in blocking pathway for T to enter the PCa.....not necessarily much to do with serum T level?

[Heykm01 in reply to maley2711]

I should have been clearer - Jack listed two concerns - 1) a rise in T and 2) that this is a predictor for faster transition to CRPC. My comments refer to the latter.

[dhccpa in reply to Heykm01]

Reply to TA and he'll answer that as well. Otherwise, he won't see it.

[jackwfrench]

Hmm that aligns with TA saying its the ADT that may be starting to fail. Thx