My first PSA test three months after having HIFU treatment has come up with an encouraging figure of 0.4, despite the fact that I had focal treatment and therefore have prostate tissue remaining. In e-mail correspondence with a friend, who also has PCa, I mentioned that I am taking into account the fact that I had three months of hormone therapy which finished at the end of September 2009, and the after effects of this could still be affecting my PSA reading.
I do not have a copy of Dr. Patrick Walsh's book 'Surviving Prostate Cancer' but my friend pointed out to me that on page 246 Dr Walsh writes "...another extremely important fact...about hormonal therapy: It is effective only while a patient is on it. The day you stop taking it is the day it stops working."
Now, Dr Walsh is an expert; I am not. However, much of what I have read at various forums and from other sources, has led me to believe that it takes time - sometimes many months - for testosterone to revert to the level it was prior to ADT. I read about instances of people who have been on ADT for longer periods than I was, taking perhaps 12-15 months to regain a reasonable testosterone level. As the reason in the first place for reducing testosterone levels is to inhibit the growth of tumours, I would have thought that as long as testosterone levels remain low, the inhibitory effect would continue?
Additionally, I know of at least one trial in the UK where patients are not eligible if they have had hormone treatment within six months of the start of the trial, because it is deemed that this could skew the figures.
In my case, my hormone treatment was administered as a three-month injection, as opposed to tablets (which I assume Dr Walsh is referring to), and it seems unlikely that there would be a precise cut-off point at the end of the three-month period. If libido, or lack of it, is any indication, my testosterone levels did not start to recover until about 3 months after the end of my period of hormone treatment.
I will be interested to hear the comments of others on the subject.
Age - 67
PSA – 7.8 ug/L. in February 2009
Gleason – 7 (4+3). T stage – 2b. Prostate size - 52 cc
July 2009 - ADT (Prostap) for 3 months to shrink prostate with a view to brachytherapy
September 2009 - prostate reduced in size but flow still to slow to allow brachytherapy. Told that surgery is only option
30th October 2009 - Focal HIFU with Mark Emberton in London UK