PSA and testosterone recovery

Hello Cinderella and the Ugly Sisters . That is a good PSA after radiotherapy and ADT. If it is still going down then it is possible that you still haven't reached your nadir - don't forget that radiotherapy can continue working for 18+ months. I have linked in the previous thread you posted on this subject rather than repeating things.

 After Hormone Therapy Stops 

I am assuming that your testosterone level is in ng/dL . If this is the case then you are no longer at castrate level. I think you were on HT for 2 years but if your last implant was in August 2024 it should have come out of your system. You may still have some of the side effects and it can take as long as 2+ years for the testosterone to reach its highest level. With older men it is found that they might not reach the testosterone level they had prior to ADT treatment or even reach non castrate level.

Yes you assume correctly nanograms per deciliter, the standard measurement used in blood tests to quantify the concentration of substances like testosterone. I would have expected a reading of above 300 ng/dl. Thanks.

Actually apologies my PSA was 0.018 ng/ml not 0.14.

Unfortunately there is no guarantee that the testosterone level will return to pre treatment levels. The two main predictors are age and length of ADT.

That PSA is considered undetectable which is a brilliant reading.

I find it perplexing that the various health authorities don't all talk from the same Hymn sheet. In Devon the hospital have a system called MyCare, and they report testosterone levels in nmol/l (multiply by 28.8 to get ng/dl).

According to MyCare typical testosterone levels for somebody in their late 60's is between 7 and 25 nmol/l (between 200 and 700 ng/dl). That makes a figure of 284 look quite promising.

Well let's hope it continues. One day at a time.

The bit that confuses me is understanding whether being at the low to medium end of the scale is more beneficial than being at the top end. My logic, albeit flawed is that a higher testosterone might fuel the rise of PSA.

Your little blighters have been dealt with by the radiotherapy. Any rise in PSA apart from the bounce or levelling off after coming off HT will be due to cells having escaped prior to radical treatment. From what I have read there is no causative relationship between testosterone levels and prostate cancer after radical treatment.

If you want more information on the kinetics of PSA recovery after ADT then this might help.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9826908/

Ok thank you, I read that, very technical for a simple man like me but I see that the recovery to my current level of testosterone from castrate level is satisfactory given my age and the duration of my ADT.

I think there is a causal link between testosterone and PSA and also prostate growth. Nonetheless, as you say , it would appear - at this stage- that the radiation has done a job. The risk as you also say, is that mets may have escaped prior to treatment and given that my cancer had a high Gleason that is possible.

There are many wise sages, and some on this forum who would advocate three years ADT treatment to mitigate against such risks and they may be right, however, the improvement to my  health and generally wellbeing after coming off two years of ADT treatment has been remarkable. I place my faith in a higher power and hope that I am one of the lucky ones. Only time will tell.