PSA and Testosterone

My husband just got his latest PSA today and it is up from 0.0. Still undetectable but now a cause for concern (0.07). My husband and I have had "issues" over food. I try to keep him on a healthy diet and he tries to sneak in all of the junk food that he can. I believe that you have to do all that you can to avoid a BCR, and that food matters.

My husband spoke to one of his clients today after he got his latest PSA score. This client is on hormone therapy for PCa. My husband just had his testosterone levels checked and the result was 475. He was told by the PA that these levels are high. My husband's client told him that his high testosterone was his problem, not his diet. Can a naturally high testosterone level fuel a relapse? My husband had EPE (but negative margins) so I have been on edge for the past 2 years since his surgery, waiting for his PSA to rise. I suspect that there may be some micro amounts of cancer somewhere - either in the area where the prostate was or elsewhere - and held in check by the immune system or else replicating. So I guess my question is - given his EPE - does anyone know if naturally high testosterone can be a cause of a rising PSA.

I am quite distraught by this latest turn of events. I am not a naturally optimistic person, and tend to worry a lot. I have not been able to move on psychologically because of a combination of worry about a BCR and stress stemming from his anxiety over sexual issues caused by his surgery.

Bluebird,

After my RRP (Da Vinci) and a few months of PSA < .01, I went back onto Testosterone supplementation; that is I get special injections to PUSH my testosterone into the high range enjoyed by your husband.

I'm on this 'trip' because my URO and Endo agreed that testosterone post RRP is not a particular danger -- this is the new Testosterone Saturation model -- However, there is always a caution.

I'm a bit adventurous so I went back onto Nebido injections. (Read my story in my profile)

Bluebird,

Your husband's T level is well within the normal range it is very unlikely that his T level makes any difference when compared to some other level his PA might thing of as "normal". It is true that if your husband's PSA level is starting to creep up -- which is not yet indicated; one data point is not a trend -- then his doctors could probably stop the rise (at least for a while) by lowering his T level but for it to make any difference at all they would have to chemically castrate him. Small changes in T level -- moving it around within the "normal" range -- make no difference at all and there is some evidence that high-ish is better.

For a bit of background, you might read this article in European Urology: Goodbye Androgen Hypothesis, Hello Saturation Model. Morgentaler (the author) is a bit of a maverick. He is going against the conventional wisdom of generations of doctors, but he has pretty much all of the recent research on his side of the argument and the conventional wisdom is coming around.

Sorry to read this news. I understand why you are concerned. I've so many PSA readings in the last 3+ years that I cannot recall and I get a case of PSA anxiety each time. However, the fact that the doctor's office drew the blood does not guarantee it isn't a "bad" test. The errors that occur do so at the lab. It can be human error or analytical error. Biology isn't always exact. I would take the test again before worrying too much. Easier said then done, I know.

Mine was .07 5years after surgery. Works for me. I don't do psa tests any more. If I ever become symptomatic, I'll get one. Till then……. well you get the picture. I hope whatever is causing you distress will be resolved to your favor….and sooner than later

bluebird123,

Your husband's testosterone level is quite normal. And, the 0.07 PSA feels high compared to 0.00, but is actually very low. I agree that waiting a few days and then a retest is a good idea.

Your husband is under the care of Dr. Mulhall (deep expertise in testosterone topics) and Dr. Tewari (deep expertise in Prostate Cancer). You are in very good hands. I suggest you avoid further anxiety by asking their expert opinions on these topics. I hope that they will reassure that everything is ok.

-Gedman

Bluebird, I did a quick query on the normal range of Testosterone and found the following explanation. This also matches the range that shows up on my blood work tests.

Male Testosterone Levels

Normal testosterone levels in males vary markedly with age. For the first few months after birth, levels range from approximately 70 to 345 ng/dL, then drop to less than 10 ng/dL until age 8 to 10, as measured at Quest Diagnostics laboratories. With the onset of puberty, levels rise gradually through the teen years to as high as 1,000 ng/dL. Normal adult values range from 250 to 1,100 ng/dL, with an individual’s testosterone level dropping slowly within this range beginning sometime after age 30. Different laboratories may have slightly different normal values depending on the test method used.

So as the others have said, I would wait for more confirming PSA tests and not put too much fear into his quite normal Testosterone reading.

My best to you both,

Sonny