T=1000+ While on Xtandi Monotherapy

At the moment, the Xtandi is blocking the testosterone from energizing his prostate cancer..That's how it works...You are right, yours is not a typical situation...So it's impossible to theorize how long the Xtandi can keep his PSA under control with nothing helping to suppress his "T" level...

Peanut:

I am on mono therapy Xtandi currently. The action of enzalutamide is that it stops the metabolism of T by the cells at the androgen receptor location on the surface of cells, including tumor cells. Thus T that would have otherwise been converted within the cell remains in circulation. This leads to a rise in T from whatever level is natural in each man so treated. Casodex (bicalutamide) and other similar drugs act in a similar, though less efficient way. This is why Casodex is prohibited in Olympic athletes because it leads to higher T than normal which can possibly be used as an advantage in competition and training. As long as the psa and scans are stable it is of little consequence, in my opinion.

Tarhoosier:

Since you brought up the training/athletic aspect, have you attempted any workouts while on Xtandi monotherapy? My husband's doc said he would not be to build any muscle while on the med, just maintain what he has. But we have added a weight training routine the last 3 to 4 weeks and hubby is dropping some weight and toning up. He is very pleased and feels better.

Also, what is your psa now? Onc says husband might be able to take a break from Xtandi eventually if he gets psa low enough for long enough. Any thoughts in this direction for you?


Fairwind:

Please keep us up to date on your BAT experiences if you go that route. I've heard of it. Do you have a good study to reference if I wanted to read more?

Think about this like your husband's doctor:
It's highly unlikely that the testosterone receptors will function any different whether the T level is 600 or 1000.

I have been on Enzalutamide monotherapy for 4 months and my testosterone has increased from 180 to 580. PSA fell from 8.6 to 0.4 at month 2 and was 0.2 at month 3. I am age 51 and had some mild side effects the first 3 months but my body seems to have tolerated well. It has decreased my blood pressure and pulse slightly. I am more sensitive to high-sodium food intake later in the day. I limit alcohol consumption to 1-2 beers a day as the blood thinning effect of alcohol appears to enhance some side effects (sleep breathing patterns and irregular pulse). One very noticeable side effect is that the drug has reduced my cardio-vascular endurance and when I am exercising or performing strenuous activities I have occasional shortness of breath and a higher pulse rate and require more frequent rest periods. I am more sensitive to heat stress. I have had some loss in cognitive function. My vocal chords seem to be affected. During months 1 to 2 I had some muscle soreness and cramping in my spine which has moderated. Have had some muscle loss but weight steady at 180 lbs.. No change in lipid profiles but I am having wider fluctuations in glucose level which has swung from 70 to 150 based on recent testing. My blood sugar has always been around 100 so I have had to start snacking a little between meals and thinking about getting a testing machine soon.

Regarding psychological effects it has of course changed my physical relationship with my wife. I explained to my employer that I was beginning a cancer treatment and that caused some confusion about the ability to perform my job and how long I will be around to work which has somewhat mediated for the time being although they have been considering adding another person in my current role.

My general focus has changed to preparing for a shorter life span (getting finances in order, preparing home for sale and downsizing possessions in order to relieve burden on spouse). Also, bought new bicycles and trying to spend more time together with spouse daily and on weekends. Have been getting some sporadic counseling.

Oh well, enough for now. Hope everyone has a good labor day weekend! Got to get to work.

I am 6 years post-diagnosis with PCa and have had RALP and SRT. I then had a 3-year period of stable PSA at 0.2 before starting TRT for 10 months after which my PSA begin to increase with a 2-month doubling time. No radiological evidence with standard bone/CT scans or Axumin PET.

good PSA number.

Andrew