Questions about testosterone after HT is stopped

I am sure that testorone supplementation is undertaken and others can explain that, but it is not for me.

I had 12 months ADT and the last infusion was Oct 2014, so primary effects should have been done by Jan 2015. I know it takes a lot longer than that for effects to wear off and it is only recently that I have started to feel somewhat normal again. Still have no libido, but at 70, neither I nor my wife, are too worried about that. Still have the occasional hot flush, mainly at night time, but my energy levels have definitely picked up.

I think I was one of the lucky ones who didn't find ADT too debillitating, and I am glad to be off it, but do understand it's impact particularly on younger men, however if there was the slightest risk that supplementing Testorone would affect my PSA, then there is no way I would consider it.

If my PSA rises and I need to go back onto ADT, then I won't hesitate to do so.

Chas

Krissy,

It does take a long time to recover if a man has been on ADT for more than a year. One study I saw found that the median time to recover to normal (presumably to the bottom of the normal range) was 11.7 months after cessation for men who had been on ADT for two years. I am almost exactly one year after finishing my two-year sentence and I am just now starting to get back to normal-ish.

I should probably prefix this next bit by saying that I don't think Paul would be a candidate but there are some doctors who are trying high doses of testosterone alternated with androgen deprivation as a treatment for castrate-resistant disease. All of the trials I have seen have been for men who were castrate-resistant but without symptoms or metastases. If you google for "Bipolar Androgen Therapy" you will find things like this from Science Magazine (abstract of a paper you can buy) or this from the Asian Journal of Andrology (free review that quotes all the results of the paper mentioned in Science).

While I was Googling up the above links I once again ran across "Dr. Bob" Liebowitz' website. He is a fairly well known oncologist who uses high dose testosterone as one of the options in his bag of tricks, even for men with advanced metastatic disease. Here's a link to a video he did made two years ago. He talks about testosterone as a treatment starting around 57:20. He quotes a lot of old research and individual case studies but he is something of a maverick on testosterone and he might counter that the mainstream of medical science has wandered off into the weeds on testosterone and prostate cancer.

www.compassionateoncology.org/video-lectures/our-three-pronged-protocol-for-treatment-of-high-risk-metastatic-andor-recurrent-prostate-cancer.php

I was on HT with Lupron and Casodex for 28 months. We stopped and it took 9 mos. for my T levels to peak. Unfortunately my peak was below "low normal". After three years of "low normal" we decided to supplement with topical testosterone replacement therapy with Axiron. The Axiron gave me nausea and I stopped it based on that alone. We re-prescribed a different TRT agent and I never tried it. At least not yet. My T levels are typically between 245 and 270.

They say anything over 200 is enough for prostate cancer to thrive. That anything over that level does not increase risk. I still haven't seen that study though.

I am a pT3b that had 4 positive margins 8 years ago. Still riding 0 on the PSA's...

Sorry to have crushed you unrealistic expectations prematurely, Nomar. The best (kindest) time to crush them is just when the man is figuring things out for himself. That way he can maintain a sort of continuity of hope with false hope bridging the gap where better reasoned hope seems distant and vague.

I was about half way between the 18-month group and the 36-month group which translates to a mean time halfway between 47 months (4 yr) or 73 months (6 yr).

Somehow PeterDA's minimum of 1 year sounds a lot better than on average 5 years.

Jerry,

Yeah, that's the one. It doesn't actually say what they mean by "recovery" so I am assuming that they mean recovery to the 'normal' range which (usually) has a lower bound of 200 to 250 ng/dl depending on whose lab you are using.

This is also the study that said...
Although 89% of men recovered normal testosterone levels after 18 months, the fact that some men remain hypogonadal after 2 years of adjuvant ADT is an important piece of information in counseling patients.

Eleven percent of the men hadn't recovered after two years and, presumably, some of them never will recover.