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Testosterone after ADT ends

User
Posted 09 Feb 2025 at 13:57

Testosterone after ADT ends: has anyone been prescribed it?

User
Posted 10 Feb 2025 at 10:29

BAT is a different situation - that's for someone who still needs hormone therapy to suppress incurable cancer.

By you saying you'd finished ADT, and seemingly had a treatment with curative intent, I was presuming you don't need further hormone therapy or any treatment.

We had one person here on lifelong hormone therapy who persuaded his oncologist to let him try BAT, but on his first Testosterone cycle, the cancer went rampant and took his life. I've never come across anyone else who's tried it. I rather suspect that to be effective, you probably need to start BAT before the cancer gets castrate resistant, but that seems like one hell of a risk if you are currently on ADT which seems to be working well.

User
Posted 25 Feb 2025 at 21:51

I had my last ADT jab 4/4/24 and right now I’m feeling like a teenager again with all sorts of erotic thoughts. My last PSA test was 4th Jan and my testosterone was 0.59, up from zero. Wonder what it will be 4th April?🤔🤔😐

User
Posted 03 Mar 2025 at 13:44

We know that low Testosterone (but not down at hormone therapy levels) is correlated with higher Gleason score at diagnosis. This and a number of other things have debunked the original consensus since Huggins and Hodges 1940's work on Testosterone and Prostate Cancer that increasing Testosterone was related to increased risk of prostate cancer. There is a relationship, but it's certainly not linear.

It's therefore perhaps not surprising if failure of Testosterone to return to normal levels might not be great for avoiding recurrence.

One of the current theories (of which Abraham Morgentaler is a significant proponent) is the saturation theory. This is that the prostate is saturated with Testosterone at the lower limit of the normal range. It can't make use of higher levels and they don't do it any harm. However, being below the lower normal limit (but not as low as castrate level) might be the most harmful level in terms of prostate cancer risk, and it is these low levels which most correlate with high Gleason scores.

This may also be why being overweight, although not increasing your chance of getting prostate cancer, certainly does increase the probable Gleason score, the chance of being diagnosed later, and the chance of dying from prostate cancer. Being overweight reduces Testosterone levels because body fat contains Aromatase, an enzyme which converts Testosterone into Estrogens, so your Testosterone level drops as more of your Testosterone is converted into Estrogens.

Edited by member 03 Mar 2025 at 13:45  | Reason: Not specified

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User
Posted 09 Feb 2025 at 16:16

It does happen now. It used to be pretty much forbidden, but it was found in some trials that it doesn't significantly increase the risk of recurrence.

Where you on it before ADT or not?

User
Posted 09 Feb 2025 at 17:49

I have not had testosterone supplements.

This patient explanation booklet explains testosterone use against  Castration Resistant Prostate Cancer - 'Bipolar Androgen Therapy'

https://pmc.ncbi.nlm.nih.gov/articles/PMC9313844/

User
Posted 10 Feb 2025 at 10:29

BAT is a different situation - that's for someone who still needs hormone therapy to suppress incurable cancer.

By you saying you'd finished ADT, and seemingly had a treatment with curative intent, I was presuming you don't need further hormone therapy or any treatment.

We had one person here on lifelong hormone therapy who persuaded his oncologist to let him try BAT, but on his first Testosterone cycle, the cancer went rampant and took his life. I've never come across anyone else who's tried it. I rather suspect that to be effective, you probably need to start BAT before the cancer gets castrate resistant, but that seems like one hell of a risk if you are currently on ADT which seems to be working well.

User
Posted 10 Feb 2025 at 12:29

Totally agree - BAT is for Castration Resistant Prostate Cancer (CRPC).

User
Posted 10 Feb 2025 at 12:41

Just had 'SmartStart' checkup and personalised gym routine programme (1 hour free personal advice at Bannatynes Gym)

The electronic check of my muscle mass reading this morning was 31% (37.4kg muscle over 119.4kg total).

One chart online says 32%-35% is 'average male' aged 56 to 75 years old.

So I have lost some, but not a lot of muscle mass whilst on nearly 2 years of ADT.  But my muscles are weak.

Thoughts?

User
Posted 10 Feb 2025 at 13:11

Blood pressure

December (just before end of ADT): 121 over 77  & resting heart rate (RHR) 97

Today (February) 101 over 67 & RHR 78

ASTOUNDING REDUCTION OF BLOOD PRESSURE JUST 4 WEEKS AFTER MY 'ADT FREEDOM DAY' OF JAN 8TH

 

User
Posted 25 Feb 2025 at 13:58

I have been following the news from ASCO Urology 25

One study showed that men who's Testosterone went back to normal after hormones and radiotherapy actually did better:

not sure what this mean to us

 

User
Posted 25 Feb 2025 at 16:48

What does the abbreviation "HR" in that link mean?

1. It seems to be natural testosterone recovery that increases chances of survival. I wonder if supplements have the same effect? 

2. The paper referenced at the bottom which is 7 years older. It seemed very sure that 18 months ADT is just as good as 36 months, and with better Quality of Life.

User
Posted 25 Feb 2025 at 20:02

Natural recovery could mean your testosterone returns after about a year. Regardless of the return of testosterone,  your QoL will probably keep improving over the next few months, even if your strength doesn't jump back to normal.

I think I'd be right in saying that if you have testosterone replacement it could suppress your natural ability to produce testosterone. If your testes have shrunk, they won't increase their size while taking TRT, which might be an argument to wait and see if you get testosterone back naturally.

Jules

Edited by member 25 Feb 2025 at 21:50  | Reason: Not specified

User
Posted 25 Feb 2025 at 21:51

I had my last ADT jab 4/4/24 and right now I’m feeling like a teenager again with all sorts of erotic thoughts. My last PSA test was 4th Jan and my testosterone was 0.59, up from zero. Wonder what it will be 4th April?🤔🤔😐

User
Posted 02 Mar 2025 at 14:39

The trouble is that half of patients never recover testosterone naturally, and those that do take up to 5 years.

User
Posted 02 Mar 2025 at 14:40

New research this week

Men with prostate cancer hypogonadal after ADT & RT:

"TESTOSTERONE THERAPY was NOT associated with rise in PSA

"No cases of PC recurrence"

Amusingly one patient was refused trial because his doctor was afraid of TTh

https://tau.amegroups.org/article/view/135044/pdf

User
Posted 03 Mar 2025 at 03:40

Originally Posted by: Online Community Member
The trouble is that half of patients never recover testosterone naturally, and those that do take up to 5 years.

Personal opinion here but with a G9 3b [if I've got your diagnosis correct] I wouldn't be in a hurry to add testosterone to the mix of recovery. Mine came back with a vengeance after one year at age 77[G9 EBRT and HT for 21mth.], as did my gonads, which seem to be pretty normal size now. My GP reckoned it had something to do with the exercise I do but ... ??? 

It might not change the odds of recurrence much but I'd be asking my doctor if, once I'd started TT it would mean I'd be on it for life.

I don't know if this is a consideration for you but I think I'd be correct in saying that testosterone therapy for a person with HT shrunken testes will not return them to their normal size but rather, keep them small. This is a phenomenon that occurs with some male gym junkies who overdo the testosterone.

Jules

Edited by member 03 Mar 2025 at 04:50  | Reason: Not specified

User
Posted 03 Mar 2025 at 13:44

We know that low Testosterone (but not down at hormone therapy levels) is correlated with higher Gleason score at diagnosis. This and a number of other things have debunked the original consensus since Huggins and Hodges 1940's work on Testosterone and Prostate Cancer that increasing Testosterone was related to increased risk of prostate cancer. There is a relationship, but it's certainly not linear.

It's therefore perhaps not surprising if failure of Testosterone to return to normal levels might not be great for avoiding recurrence.

One of the current theories (of which Abraham Morgentaler is a significant proponent) is the saturation theory. This is that the prostate is saturated with Testosterone at the lower limit of the normal range. It can't make use of higher levels and they don't do it any harm. However, being below the lower normal limit (but not as low as castrate level) might be the most harmful level in terms of prostate cancer risk, and it is these low levels which most correlate with high Gleason scores.

This may also be why being overweight, although not increasing your chance of getting prostate cancer, certainly does increase the probable Gleason score, the chance of being diagnosed later, and the chance of dying from prostate cancer. Being overweight reduces Testosterone levels because body fat contains Aromatase, an enzyme which converts Testosterone into Estrogens, so your Testosterone level drops as more of your Testosterone is converted into Estrogens.

Edited by member 03 Mar 2025 at 13:45  | Reason: Not specified

User
Posted 03 Mar 2025 at 22:54

Thanks Andy, interesting post though it raises as many questions as it answers.

Jules

User
Posted 04 Mar 2025 at 21:09
Wow Andy, you learn something new every day!

Thanks!

User
Posted 04 Mar 2025 at 21:43
Thanks for that information Andy, it may be pertinent to me.

While Dr Morgentaler doesn't seem to have published many experimental papers recently, he is active with reviews and opinion pieces which give helpful numbers. If prostate saturation is about 250 ng/dl in American money (around 8-9 nM for us) but the threshold for deficiency is around 400 ng/dl / 14 nM then from my last measurement my testosterone explains my frustration about libido but any supplementation wouldn't increase recurrence risk. My hospital isn't in the habit of measuring testosterone routinely so it may have changed since measured, but it is a point to discuss with the consultant at my next appointment.

Thanks too to NorthernMan for creating the thread with this discussion.

User
Posted 05 Mar 2025 at 10:00

After a year or so, your testosterone levels may naturally return. Even if your strength doesn't immediately return to normal, your quality of life will most likely continue to improve over the next months regardless of testosterone levels.

 
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