Just a general enquiry to all you knowledgeable people out there.
On numerous occasions I have seen posts were people when replying have enquired what the individuals testosterone levels where, or that they should get them checked. Now we all know that testosterone feeds PC (and I assume that high levels even more so?), and I have read and I quote - “They found that men with the lowest levels of testosterone had a 23% reduced risk of developing prostate cancer compared to all the other men. Interestingly, men with very low levels of testosterone who did get prostate cancer 57% of which were more likely to develop an aggressive form of the disease..” Oxford Uni 2018.
So my question is to those on here that enquire about or suggest getting it tested (or indeed anyone else with educated input) is to what end is this done, how would you translate an individual’s results and how useful are they in the grand scheme of things?
I ask the question because at the moment I am on AS and have persuaded my GP that I should have mine tested. But in all honesty I’m not totally sure what I should make of the potential results!
All input great fully received.
Alf…
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Trident3
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1) The common question about someone's Testosterone value is posed to people already under ADT in order to verify that their treatment is still effective.
2) There are contradicting theories regarding out of average value of Testosterone "feeding" PCa. For example in BAT a Supra Physiological value (>1500) is considered a cancer cell killer. Another theory, the name of which escapes me now, claims that within the normal range, there is a cut-off towards the up-side that saturates (plateaus) its effect of "fueling" PCa.
You misunderstand the relation. Many accept saturation theory - that androgen receptors are fully saturated even with about 150 ng/dl of T. T also plays a role in keeping healthy prostate cells healthy, so normal levels are good for us unless we have prostate cancer.
it is useful if going on adt being on ADT or checking for return of testosterone after ADT treatment. Most people on AS won’t have a benefit from level
There are several reasons I track my Testosterone ("T") as well as PSA. On Active Surveillance, the main reason would be to establish a baseline for comparison later on. Normal is a big range, something like 280 - 900. If you have to use ADT in the future, you want to get a T score and PSA just before starting ADT. I like to get tested monthly because I feel better knowing what is going on. Depending on which medication you use, your T should ideally go to "undetectable" - using LabCorp in California, "undetectable" is a value of <3. If your treatment is getting the T as low as possible, you are having the best deprivation effect on your cancer. I just started ADT again and using Orgovyx my T went from about 185 to <3 in less than 3 weeks and my PSA dropped from 2.5 to 0.225. I hope to keep the T undetectable and get my PSA down to <0.006 which is the lowest detectable level using LabCorp's "ultra-sensitive", test monthly. Unlike you, I have very aggressive PCa and want to do what I can to detect changes. If you try ADT and are able to take intermittent breaks, you will want to know A) how fast the PSA returns, B) how close it gets to recovering your baseline reading, C) When it stabilizes - so that you can see if your PSA level also stabilizes or continues to rise, which would suggest trouble. Hope that helps. Be proactive and insist on the tests you want.
Morgentaler's Saturation Model is well accepted, and is supported by many different data sets. Most researchers agree that the rollover point is closer to T = 250 ng/dl.
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