Does anyone know on average how long it takes to recover testosterone levels after short term (6 months) ADT treatments (Lupron and Bicalutamide) combined with EBRT? .
I have found the side effects of the ADT (depression, mood swings, loss of libido, loss of muscle mass, loss of concentration, hot flashes, night sweats, fatigue, etc.) to be surprisingly unpleasant, and am eager to return to some semblance of physical and emotional normalcy.
Can anyone provide a link to an appropriate nomogram, personal experience or any other helpful information?
Also, does anyone know on average what percentage (50%? 75%?) of pre-ADT testosterone levels are needed to recover from the symptoms?
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Murph256
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I believe that testosterone [T] levels should be boosted after ADT. The recovery of T is very slow & uncertain. Also, men with PCa often have low levels before ADT. &, T levels often do not return to previous highs.
The cessation of ADT is followed by a period of continued castrate T, & a period of hypogonadism plus a period of barely adequate T. During the latter two phases, estradiol may well be dominant. In my view, this is something to be avoided.
Thanks for posting this info Patrick. Affirms my decision to stop Lupron after 18 mos. instead of the recommended 24. I guess it was too much of a shock to believe they could drop from the old 36 mo. standard all the way down to 18 so they selected 24 mo and put it on cruise control. When I asked my RO and MO if they had any clinical data to support this, they said no. Also, I'll wait and see what my OH curve is looking like and if I don't like the progress I'm getting juiced up. I was reading a recent article in Urology Times out of UC-Irvine that, at least with post RP patients, normal T levels do not accelerate progression. They also state that low T levels may actually hasten the time to biochem recurrence.
That's an interesting reply. In hindsight, I did not do enough due diligence regarding the side effects of Lupron and Bicalutamide. As I've progressed through Sloan Kettering, I've found the side effects of most of my treatments to be over-stated. For example, after my RP, yes, the catheter was an annoyance for a week, but I found the pain, incontinence and even the ED to be very manageable. The same was true of my EBRT. I only had very minor bowel and urinary issues. So I did not expect my side effects from the ADT to be serious either. And in fact my MO even stated something to the effect that the most severe side effects would come from my radiation, not the ADT. Nothing could be further from the truth. I have found the side effects from ADT to be a huge ongoing source of misery. All that said, I probably would have gone forward with the ADT anyway, but with a different mental approach.
Agree. For that reason, I have strongly resisted promotion of ADT despite being told repeatedly it is "significantly better." The RO and the MO were not forthcoming about side effects or were dismissive, saying "you can make a few lifestyle changes and we will radiate your chest so that you do not get breasts." Truthful, full disclosure should be the SOC.
I had ADT for 9 months 3 x 3 monthly injections and my consultant said he would expect the effects to be with me for at least 9 months and up to 18 months after stopping but getting less all the time testosterone had recovered by the 1 year mark - it could have recovered a little while before that but I hadn't had a blood test to quantify.
"depression, mood swings, loss of libido, loss of muscle mass, loss of concentration, hot flashes, night sweats, fatigue, etc."
The etc. includes growing breasts, wearing ladies underwear, admiring women's shoes, enjoying the ballet and no longer cares who has the tv remote control. But heck who's complaining....
I had a six month eligard (ADT) shot. About 2 or 3 months after the scheduled duration my T level had recovered nicely. My urologist was surprised and asked if I was taking T supplements or injections. Nope. I did continue my weight lifting and aerobics during the castrate period. Any muscle loss wasn't noticeable.
2 months from theoretical end of 6 months ADT to 359 ng/ml testosterone. This is "normal" range, but I now wish I'd found baseline before beginning ADT so I'd know how this compares to MY "normal".
Is anyone out there getting Testosterone replacement therapy? I have been taking D-Aspartic acid capsules which has an action as a luteinzing hormone agonist. Have more energy, less hot flashes, and my testicles are slowly increasing in size.
25 IMRT, 39 brachytherapy seeds, ADT for almost 12 mos (Eligard, 1 mo; Lupron 3 three mo injections). Results from ADT: misery and hell. Poster child for negative side effects here.
Docs were not very forthcoming with info re return of T. Last injection was May 2019 (3 mo duration). In theory, by September 2019, I should have started to return to some sense of pre-treatment "normality." Yes, many of the side effects are far less pronounced than they were; thank god. My T was at 70 in February 2020. It roared to...wait for it...107 by May!! Woo-hoo! At this rate - approx 10 pt increase/month - It's gonna take many more months to return to my pre-treatment level of 270 (and that is a low T anyway).
So, Murph, I feel your pain. Despite my research, I was totally unprepared for the affects of Lupron and the resulting low T. Two things seemed to help me: exercise (and no gym persona here) and medical marijuana (flavored gummies). Would I agree to ADT again? Dunno. It pretty well resulted in worst 2 yrs of my life. Hang in there. Good luck to you.
I feel your pain. I was on ADT for 6 months and it took another 4 months for my testosterone to recover to acceptable levels. During that 10 months I suffered severe depression and mood swings bordering on suicidal.
Eventually, when my PSA returns, I’ll have to go back on ADT. But for now, I’m going to enjoy my testosterone while I can.
I don’t understand why some members of this forum tolerate ADT so well, and some are so severely affected.
my treatment was about the same as yours....one year after end of the 6 month lupron and 45 rounds of rads my testosterone was back in the 500`s....probably about normal,,,,,good luck
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