Testosterone level undetectable?

Not only is your "T" level unusual but your entire journey is just as unusual...Have you looked into getting into a clinical trial or getting an opinion from one of the "Centers of Excellence" ? Perhaps see if Xtandi offers any benefit....? If you are still healthy and feeling good, I would be going after this tooth and nail...Use every tool available....

Klotz is one of the PC deities - great idea to see him. Taxotere + ADT is the best known therapy for a case like yours. You can ask him about radiation or surgical "de-bulking" - it's still experimental at this point.

You're right that there are few clinical trials for men who are still hormone sensitive, which is a shame because I think you are more likely to benefit from concurrent use of immunotherapies, radiologicals and growth factor inhibitors. Klotz would know if there are any in Canada.

I think undetectable testosterone may be a lab error. Did they check that with a fresh blood sample?

- Allen

For debulking - not seeds alone - that certainly wouldn't be enough. Perhaps seeds or HDR brachy combined with IMRT, or perhaps just SBRT (Loblaw has a "high risk" trial of that at Sunnybrook). An advantage to SBRT debulking would be that you could take out the known mets with SBRT during the same treatment. This is the kind of thing LupronJim had done - he had a single identified lymph node met, and had concurrent SBRT radiation to his prostate and pelvis, all in 5 treatments. He also took Zytiga, and used Provenge to enhance the abscopal effect. He can tell you how he got it all approved by his insurance - I don't know if it would work in Canada.

Sex Hormone Binding Globulin (SHBG) is part of the negative feedback we have for T. As T (or DHT, estrogen, etc.) increases, your body makes SHBG to bind up the excess T so that it's not available to your cells. That's why doctors sometimes measure "Free T" instead - the T that's available to your cells after the rest gets bound up. However, with zero T, you wouldn't have any free T either. Another lab test should clear up the mystery.

- Allen

Thank you Lisa for the response. I will keep looking for your posts to see how you progress, and what the treatment plan will be.
Best wishes and good luck!

Hello "Travling Guy" From Canada ---

We have corresponded in the past, both of us in the same age bracket, and both of us with initial PSA scores over 100 at the time of diagnosis. We have both also chosen to undergo chemotherapy with Taxotere.

I looks like your Taxotere chemotherapy treatments have really brought down your PSA numbers. I hope you feel very encouraged by that, and it looks like they continue to drop. I hope this trend continues for you.

I have tried 3 kinds of hormone shots over the past few months. First was Lupron, then we tried Firmagon for a couple of months, and the past two months I have now been on Zolodex shots. The attempt was to bring my testosterone levels down to a lower level. The Zolodex shots have now brought my testosterone level down below 20, so my oncologist was pleased with that result.

We are watching the nodules which have re-appeared in both of my lungs. They disappeared for perhaps 18 months following the original treatment with the Lupron hormone shots. They have now re-appeared the last couple of months, but my PSA is still in the low decimals. So we will watch the PSA and I will probably undergo another series of Taxotere chemotherapy treatments when the PSA begins to spike upwards. My oncologist is watching it very carefully. This next time, he believes that I will undergo 10 Taxotere treatments, which would stretch out over the course of 30 weeks. The first series of chemotherapy treatments was only 6 treatments, lasting for 18 weeks. So --- we are in a "wait and see" pattern right now, as my PSA stayed stable from last month.

Most oncologists like to see the testosterone level drop below 50, but many oncologists like to see it drop below even 20, if possible. So I was pleased that the Zolodex shot brought my testosterone down below 20 points this past month. I continue to go to work each day and seem to have my usual energy levels. I feel fortunate in that.

I am greatly encouraged by the drop in your PSA levels following your Taxotere treatments. Please continue to keep us posted on this website.

Continued best wishes,
Cyclone

Post Edited (ISU-CycloneFan) : 6/4/2015 4:40:22 PM (GMT-6)

Dear Tall Allen,

Thanks for sharing your expertise with me. The lung mets were biopsied originally in the fall of 2013, when I was first diagnosed. Having the lungs biopsied put me in the hospital for about 3 days, but it confirmed that the lung mets were associated with my prostate cancer.

With Lupron shots, the lung mets were resolved within a few months, but have now begun to re-appear. My PSA is 0.15 at this time, but recent lung scans showed the beginnings of lung mets once again.

I will discuss your idea about a "chemo cocktail" with my oncologist at my next appointment, as you have kindly suggested to me. Ironically, I was allergic to Taxotere treatments, so they ended up having to infuse me first with a liquid Benedryl type I.V. before the Taxotere treatments were given. That worked !

Despite that, my side effects from chemo were very tolerable and I was able to work each and every day. I know I was fortunate in all of that. With the chemo treatments, my PSA fell to the lowest levels ever.

You have reached out to so many people through this website. I hope you realize the gratitude that we all feel for the kindness and expertise you continue to share.

My gratitude expressed to you,
Cyclone