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Posted 3/9/2015 8:07 PM (GMT 0)
If PCa becomes castrate resistant, will your T-Levels rise before PSA or will they both rise at the same time.

Just wondering if docs ought to be monitoring T-levels also.
Posted 3/9/2015 8:14 PM (GMT 0)
Not sure as my T-Level is just 13, but PSA rose to 42 from 30 something. Now onto Zytiga.
Michael
Posted 3/9/2015 9:46 PM (GMT 0)
I think the castrate resistant means that the cancer has mutated and no longer needs testosterone to grow. Thus the reason for additional treatments.
Posted 3/10/2015 6:38 AM (GMT 0)
I asked the same question,as Gary's t level has not been checked in years. Apparently once you have achieved castration level, and stay on HT, testosterone doesn't come back. The term "hormone resistant" causes confusion, as the cancer isn't resistant to the lack of testosterone, but has mutated to survive without it. Apparently any t level under 50 is considered good enough. The other thing that is confusing is that zytiga and xtandi are also considered hormone therapy, I don't think they are used to further lower t levels. Perhaps someone could enlighten us on this.
Beth
Posted 3/10/2015 7:44 PM (GMT 0)
A base size of only one, but in my husband's case, his PSA became detectable 7 months ago and has steadily increased since then, but his testosterone has stayed below detection levels in monthly testing.
Posted 3/10/2015 7:58 PM (GMT 0)
Castrate resistance means that the disease is progressing (e.g., PSA rising or radiological progression) in spite of castrate levels of testosterone (less than 50). After castrate resistance sets in, GnRH agonists (e.g., Lupron) and antagonists (e.g., Firmagon) or orchiectomy still serve a useful purpose. While the cancer doesn't need T to grow, it is still stimulated by its presence. Zytiga with prednisone and/or Xtandi are used along with castration. They prevent non-testicular sources (e.g., adrenal, intra-tumoral) of androgen and block its utilization by the cancer.

- Allen
Posted 3/11/2015 3:29 AM (GMT 0)
If your prostate has not been removed, we were told by the oncologist that there could be some slight variation in PSA levels, after reaching your nadir (lowest PSA level while on ADT). For example, if your nadir PSA was 0.02, then a month later it has risen to 0.05, while T < 50, that does not necessarily mean you are castrate resistent (if your prostate has not been removed).

The presence of the prostate will produce PSA levels that are slightly higher at castrate levels (assuming ADT is working), than for people without a prostate.

You didn't mention your PSA level increase, so this is assuming the number didn't go from 0.05 to 4, for example.

Again, this is my understanding, so someone else who is more knowledgable please cofirm, or correct.

Arthur
Posted 3/12/2015 6:55 AM (GMT 0)
Allen, thanks for the clarification I can always count on you for a clear explanation. After four years, you'd think I'd have gotten more of this figured out!
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