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Recovery of testosterone after long term hormone therapy (ADT)

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Jim Marshall (not a doctor) said ...

New agreement

At the recent Prostate Cancer Research Institute (PCRI) conference I was fortunate to meet with Jan Manarite, Executive Vice President of Prostate Cancer International. The "New" Prostate Cancer Infolink is their corporate website.

In the past we have republished individual articles from their site, with permission.

Jan has been kind enough to now give us blanket permission to republish any article, with proper attribution.

We are grateful to Jan and to Prostate Cancer International for this kindness.

This article

Men who were on hormone therapy (ADT) for 6 years took a long time to recover testosterone, if they did at all.

... end Jim

 

From The "New" Prostate Cancer Infolink:

After long-term ADT … recovery normal of hormonal function?

Posted on September 22, 2016 by Sitemaster

  2 Votes

A group of Spanish clinical researchers have reported recent data from a small study designed to address an unanswered question about the recovery of (relatively) normal hormonal function after completion of androgen deprivation therapy (ADT).

Planas et al., writing in the Scandanavian Journal of Urology, report data from a cohort of 40 patients who:

    •    Were all treated with long-term ADT for locally advanced or metastatic prostate cancer

    •    Had an average (mean) age of 71.5 years

    •    Were treated with ADT for an average duration of 74.6 months (i.e., about 6 years) and then

    •    Stopped their ADT therapy without any consequent rise in their PSA level

The men were then followed for an average of another 36.5 months (about 3 years), and their serum testosterone (T) and serum luteinizing hormone (LH) levels were determined at 6-monthly intervals after cessation of the ADT.

Here is what the research team reported:

    •    At 18 months of follow-up,

    ◦    All patients had recovered normal levels of LH.

    ◦    38 percent of patients still had castrate levels of serum T (< 50 ng/dl).

    •    Based on a multivariate analysis

    ◦    Only time on ADT was correlated with recovery of serum T levels > 50 ng/ml (p = 0.031)

    ◦    Neither age nor clinical stage at start of ADT showed statistical correlation to recovery of serum T levels > 50 ng/ml

    •    Average time for recovery of a serum T level of > 50 ng/ml was

    ◦    14.5 months in men treated with ADT for < 60 months

    ◦    29.3 months in men treated with ADT for > 60 months

The authors conclude that:

Age did not correlate with testosterone recovery in a group of elderly prostate cancer patients in whom ADT was stopped. Testosterone recovery after ADT cessation was significantly correlated with time under ADT treatment.

So what this tells us is that a significant percentage of men on long-term ADT are probably never going to regain anything approaching normal serum T levels on their own after stopping ADT.

We are aware of a small number of men who, after being on long-term ADT for several years, and stopping, then took testosterone replacement therapy (TRT) to regain normal serum T levels. That strategy clearly comes with a significant level of risk in men who were originally being treated with ADT for advanced or metastatic prostate cancer. Might that be an acceptable risk for some patients? Well, … probably only an individual patient could answer that question — and only with regard to himself.

Original article on the "New" Prostate Cancer Infolink site

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Charles (Chuck) Maack

I wrote the following paper several years ago on the subject “Testosterone Failure Following Continuous Long Term Androgen Deprivation Therapy with an LHRH Agonist (and other exacerbating conditions)”

http://tinyurl.com/n3dhzbf 

 

[Edit - As members are aware, Chuck is a prominent US cancer advocate/activist. He is not a doctor,. As he indicates in the disclaimer contained in his article, you should seek your own medical advice regarding the matters covered in his paper.]

 

 

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