Elevated Testosterone

[rainlessman]

I was on Abiraterone and prednisone for 6 months until June 6, 2024.

My blood work:

4/25/2024 Testosterone 44 ng/dL, PSA undetectable

5/28 T 35, PSA undetectable

6/6 Stopped Abiraterone

7/8 T 968 PSA 0.21

8/19 T 1475 PSA 0.54

My MO want's to do a PSMA scan in a month. I don't see many issues expressed here about elevated testosterone. What are the causes and affects of this? My QOL has bounced back very well, enjoying that.

thanks to all

[Sagewiz]

Rise in PSA is always concerning and a PSMA scan ASAP is advisable with that trend. I have been on he same protocol for 1 year and they will have me on it for another year. my PSA is steady at <0.1. However, they started lowering my Abiraterone dosage due to my extreme fatigue and they tried it at 750 mg for 4 months without change then down to 500 mg/ day for the past 4 months and the PSA remains unchanged. I'm encouraged by that.

From my reading of other's experience on here, it losses efficacy over time, so it only works as long as it works.

Best of luck on the PSMA!!

[HealthChat2023]

During a routine visit to my primary physician in May 2023 a blood test revealed a PSA level of 34. It was about 1 during my last visit. The last visit was pre-COVID so I don’t know when it had reached this level. I wasn’t experiencing any symptoms. The doctor dismissed this as meaningless because it is “ a crappy test” according to what he had been told by the AMA. But, since my cholesterol level was slightly elevated he ordered a Calcium Score test (a CT scan to test for calcification of the arteries). The Calcium Score was normal but there were incidental observations of multiple nodules in both lungs. I decided to have a second PSA level test and it also showed a PSA level of 34 so I visited a urologist who recommended a prostate biopsy. It revealed a small lesion with a 3 + 4 = 7 Gleason score but since my PSA level was 34 the doctor recommended a lung biopsy. Somehow this small Gleason score 7 lesion that hadn’t even spread to other parts of my prostate had metastasized to my lungs. (As you may know this is very rare absent metastases elsewhere.) In September, I started on both Lupron and abiraterone (plus 5 mg Prednisone) and I tolerated it very well, i.e., zero side effects. By December my PSA level had fallen to 0.05. I opted to start chemo in Jan 2024 and my PSA level immediately fell below 0.05, i.e., it was imperceptible. To my surprise side effects were still mild, although the hair “thinning” I was told to expect translated to an immediate loss of all my hair. In May, one month after I completed six 3-week cycles of chemo, a CT scan showed that the lung nodules had “decreased in size and number markedly. “ My PSA level is still <0.05. I’m now back to just Lupron and Abiraterone, but my blood pressure started to rise (in accordance with doctor’s order I’ve been testing it daily since last Dec) so Amlodipine was prescribed. My hair grew back in June (its now white) so I now feel great but I have started feeling stiffness in my knees and sometimes feel warm at night (mild “hot flashes”) so when that happens I have to shed a blanket. I “walk briskly” (3.5 mph) on my treadmill EVERY morning for 30 minutes (even during chemo) and when I have time I complement this with 30 minutes on my rowing machine and/or 3 circuits of light weight training for 45 minutes. I was very fit when I was a teenager but became sedentary for decades (I’m now 67) so adopting this daily exercise routine has left me feeling better than I felt before I was diagnosed with prostate cancer. I didn’t look overweight before but my weight has fallen from 220 to 190 and I feel better at this weight. The loss is probably due primarily to cancer, but I cut out sweets last Sep, and switched to green tea instead of a cup of coffee in the morning so this, plus the exercise, has helped, I think. I’m told that the Lupron and abiraterone can cause a weight gain and that hasn’t happened. I know that ADT is just a suppressor and that it can cause a loss of muscle mass and bone density over time but I’m hoping a treatment will come along within the next few years that will allow me to stop taking Lupron and abiraterone. I decided against radiating my prostate because I was told it wouldn’t help and would just introduce side effects, especially since they would have to radiate my entire prostate because the cancer has metastasized. I have provided more info than was required to answer your question but I hope this helps. If I missed something let me know. Now that I’ve given all this background info I can be more specific and concise.