Posted 12/18/2008 6:33 PM (GMT -6)
I'll give you a call on this one...but for everyone I'll explain...I'll call you just because it gives me a reason to.
There is no correlation between PSA and testosterone per se. However, there is a desired testosterone level while on medical castration and 56 is even high. Some prostate oncologists (Strum, Lebowitz, Myers, for example) subscribe to the need for testosterone levels to be at or below 20 for the castration to be fully effective against PCa. Others say under 50, which is more generally acheived with Lupron (or another LHRH agonist)/Casodex combination. Some people simply have higher testosterone production, but it isn't a good thing when combatting prostate cancer. Some of the ways to lower it further are to change fom 6 month or 4 month depots to monthly LHRH agonist injections, and/or add finasteride (Proscar) to attempt to acheive a lower T level. Another way is to have the testes removed (orchiectomy) and discontinue the LHRH agonist. Your center is on track testing for and addressing this issue. You have the right PSA, but to maintain it they are taking precautionary action. I would ask them if they have the dihydrotestosterone (DHT) levels as well and if it is in the acceptable levels. Testosterone is your enemy if cancer is still present, and DHT is a hundred times more powerful than testosterone in feeding PCa. So both need to be monitored to maintain the most effective androgen deprivation therapy.
I'll talk to you soon...This stuff is hard to explain, but again, your center is doing the right thing.