Low Testosterone and value of continuing Hormone Therapy

[saniku]

83 year old male with a question: My understanding is that the role of hormone therapy is to lower one’s testosterone level. Does hormone therapy provide additional benefits in fighting prostate cancer beyond lowering testosterone levels?

I was diagnosed with high grade prostate cancer (Gleason 10) in late November 2017. I immediately started Lupron and continued Lupron/Eligard until Nov. 16, 2020 (almost 3 years) At that time PSA doubling suggested radiation. I underwent 25 IMRT sessions in Dec 2020. Upon completion of the IMRT my PSA and testosterone levels were acceptably low so I chose not to undergo further treatment at that time and as of Jan.2024 I am still off any treatments. Thus I was on treatment for three years and now off for the last three years.

Here is a sample of some of my more recent 2023 PSA and testosterone readings.

1/31/23 PSA 0.66 T 62.6

5/4/23 PSA 2.86

8/2/23 PSA 2.79 T 76.5

11/8/23 PSA 3 T 62.6

With testosterone levels currently hovering between 62.6 and 76.6 I wonder if there is there any advantage on resuming hormone therapy since testosterone levels are already quite low? After three years off treatment I still have unpleasant lingering effects of therapy thus the question.

I do have stage 4 PC and a late May 2023 PSMA showed cancer in the prostate bed as well as a small spot on a rib. My next appointment with my urologist is in early February. We’ll decide then what course to take.

[Tall_Allen]

T is not low enough to prevent further spread. Ideally, it should be below 20.

[Wassersug in reply to Tall_Allen]

Actually Tall_Allen is not only right but a recent paper by Laurie Klotz suggests that getting T below 10 is even better. The full paper is free on the internet. Here's the citation:

Testosterone nadir and clinical outcomes in patients with advanced prostate cancer: Post hoc analysis of triptorelin pamoate Phase III studies

L Klotz, T Tat - BJUI Compass, 2023 - Wiley Online Library

[Derf4223]

You are letting a urologist run things? Get an MO and RO stat.

[Atdabeach in reply to Derf4223]

Agree times 100. Cancer metastases outside the prostate, especially to a rib, are way outside a urologist's field of expertise.

[arete1105]

I was on Lupron until it appeared Lupron no longer worked,(several years later) then they suggested Zytiga, the next level of hormone therapy. But scan showed it would be better to start chemo, which coming up is the 6th out of 6 sessions. My Gleason was 7. Current scans show that some cancer decreased while other areas increased slightly. I will probably continue on with the chemo. I have stage 3+.

[j-o-h-n]

Get an M.O. asap.........

Good Luck, Good Health and Good Humor.

j-o-h-n