Zoladex

Hi Steve

I have been on HT for 12 months with an initial PSA of 182, just before RT this was down to 1.37. I have just completed my 20 doses of RT and have been told hormone treatment for the next 2 years and that's you done - we will just keep a check of your PSA each year.

So yes - I think you are good to go with a PSA of 0.01 that's great - well done.

Kind regards - Brian.

What was your original diagnosis (PSA, Gleason, Staging)?
Was your treatment with curative intent, or to manage the disease long term?

Hi Andy my psa was 20 when I was first diagnosed with a gleesen score of  

7 4+3 . And was told it was to manage the disease long term

hi Brian that’s reassuring as my psa was 20 when I was first diagnosed and I also had 20 doses of rt and I hope it all goes well for you 

all the best steve

Hormone therapy alone isn't curative, so you wouldn't expect to come off it unless you've also had another treatment with curative intent. What might be possible is to have intermittent hormone therapy treatment, where you have hormone therapy holidays. You come off the hormone therapy and stay off it until your PSA rises back to some level chosen by your oncologist, or until the rate of PSA doubling exceeds a level. You could ask your oncologist about this (not your GP - GP's tend to know very little about prostate cancer and its treatments). It will depend on your initial diagnosis if the oncologist thinks this is a possibility for you.

Hi all, I had my second hormone implant injection a couple of weeks ago. The first injection 3 months prior was Prostap but this time it was Staladex which will also be injected 3 monthly.

In the Staladex data sheet in addition to info on the lengthy list of possible side effects, there is a "Special Note".

This says the following, "Your response to treatment should be monitored by measuring testosterone blood concentrations 28 days
after each injection and before each re-administration of Staladex and additionally on the basis of other laboratory test."

I have been made aware of this in other reads about some HT's on the Internet but my urology nurse or my GP nurse who did my injection mentioned anything about this! 

Has anyone got any experience of having a testosterone check during treatments, I am just wondering if when I ask my GP about this they might say that it's not necessary and it doesn't need to be done.

I appreciate any comments on this especially those who have specific experience. 

Hi Grampy - I've had 3 hormone injections to date and I have read the list of possible side effects in the Patient Information Leaflet. I can't remember seeing anything about testosterone levels. 

I know I have low testosterone levels because of the ED side effect - there's no action there. Strange to mention though in December when I went for my Radiotherapy Planning Scan they did my bloods and my testosterone level was 0.6 (almost off the scale for a female!!).

I hope this helps - Brian.

I hadn't come across anyone on Staladex before. It's Leuprorelin, so basically a different brand of Prostap, which is commonly used.

A few treatment centres do Testosterone tests with all the periodic PSA tests although mine doesn't. Most will do it only if PSA level doesn't drop as expected.

My GP has done a couple of Testosterone tests when I asked, once when I feared the hormone injection hadn't worked as I started to get unexpected erections (my Testosterone was 0.2nmol/L which is very low even for hormone therapy, so no worries), and once when the GP was doing a whole battery of routine blood tests at age 60, I asked them to add PSA and Testosterone too, being a prostate cancer patient, which they were happy to do.

My treatment centre asked for Testosterone to be added to my quarterly PSA tests when I finished hormone therapy, until my Testosterone level recovered and stabilised. This is in part because, still having a prostate, my PSA was expected to rise when my Testosterone recovered, and indeed it did. I suspect it was also in part because my oncologist knew I'd be interested in it, as he knows I monitor and graph all my readings, and he finds them interesting too. I did post it in a comment in this community, but I don't know how to find that again.

Interesting to hear your responses about testosterone checks and results.

I found this on Internet so not sure how this relates to your 0.2 test result.

As my wife and I haven't had any sexual activity for a number of years, any ED are not a concern for us. I did experience early morning erections on occasions over the years but nothing since my HT started. (It's dead, ha!)

I assume this is due to the HT switching off my testosterone, which I'm happy about as hopefully this will be slowing/shrinking my cancer.

Thanks for your replies, Graham

Grampy74, those Testosterone levels you quote are are in American units. The rest of the world uses SI units for Testosterone, nmol/L. Divide American Testosterone units by 28.8 to get SI units for Testosterone. Also, you'll find different countries quote slightly different normal ranges for Testosterone at different ages. The US ones tend to be higher than elsewhere, to promote their rather substantial Testosterone supplement industry in making everyone think their Testosterone should be higher.

Hormone therapy injections should get you down to at least castrate level, which is generally held to be 1.2nmol/L, but there isn't much agreement on what castrate level either, and values from 0.7-1.7nmol/L are used in different places. Usually, hormone therapy injections get you lower than even castrate level.

Note that Bicalutamide when used by itself doesn't lower Testosterone. It works differently by stopping your body from being able to use Testosterone (and as a side effect, it actually pushes Testosterone up, but that doesn't matter). Bicalutamide when added to hormone therapy injections doesn't have this effect, as the hormone therapy injections will still push Testosterone down to castrate levels or lower.