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OFF-Drugs VACATION; Here I go......

VascodaGama's picture
VascodaGama
Posts: 1565
Joined: Nov 2010

My last PSA test provided me with a much wanted “bill” for a relief on the drugs.
The testosterone got lower than the previous test (from 0.33 to <0.1 ng/ml) and the PSA maintained its equal result of 0.02 ng/ml.

I was initially confused for the level of T because it has decreased but such did not influence the level of the PSA. I inquired and the lab repeated the tests confirming the results. This laboratory uses assays with LLD of <0.01 for the PSA and <0.1 for Testosterone.

The good news comes from my doctor that will stop the LHRH agonist (Eligard) until the day when PSA starts to increase again. This is the start of my “Vacation”. The last shot will “officially” end its effectiveness in May; therefore, I expect an increase of testosterone then, which will give me a relief from the side effects.

Here is the chronology of the tests since the start of HT in Nov 2010;

Nov 2010 PSA=1.0; T=3.76 (Cyproterone 50 mg-1 month plus Eligard 6-month shot)
Dec 2010 PSA=0.18; T=0.28
Mar 2011 PSA=0.07; T=0.28
May 2011 PSA=0.05 (remission) (Eligard 6-month shot)
Aug 2011 PSA=0.03; T=0.33
Nov’2011 PSA=0.02; T=0.32 (Eligard 6-month shot)
Feb 2012 PSA=0.02; T=<0.10

Sending roses to all my buddies.

VGama

Beau2
Posts: 241
Joined: Sep 2010

Hey Vasco,

Congratualtions.

Best wishes for continued continued good news.

lewvino's picture
lewvino
Posts: 1007
Joined: May 2009

I enjoy reading great news! Congrats to you and continued health.

lewvino

bdhilton
Posts: 759
Joined: Jan 2010

Great news and hopefully this is a permanent vacation but vacations are nice too…All the best to you!

tarhoosier
Posts: 182
Joined: Aug 2006

Vaso:
Well done. You are an educated patient and will respond as necessary. Enjoy, if that is the proper word.
I believe your measure of Testosterone is in nanomoles (nmol), is that correct?

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Vasco,

That's great news. Hopefully you can visit Whoopi island now.

K

hunter49
Posts: 204
Joined: Oct 2011

great news very happy for you. Keep up the zero

VascodaGama's picture
VascodaGama
Posts: 1565
Joined: Nov 2010

Tarhoosier;
The unit of measurement of the results above are in Nanograms per Millilitre.
The PSA is commonly referred with ng/mL.The testosterone is referred in three different units depending upon the results purposes. (ng/mL; ng/dL; nmol/L)
To convert Nanograms per Millilitre into the other units just multiply its units using the following conditions;
A decilitre (dL) is 0.1 L or 100 mL.
The molecular weight of the testosterone is 288.42 g/mol.

Therefore, my last Testosterone of Nov 2011 was 0.32 ng/mL or 32 ng/dL or 1.12 nmol/L. Normal levels of T in males is; 2.41 – 8.27 ng/mL or 8.4 – 28.9 nmol/L

Thanks
Smelling the roses already.
VG

alinur
Posts: 12
Joined: Dec 2011

Very happy for you Vasco.
You are a wise and trusted counselor for us.
be always as fresh as roses.Enjoy the vacation.

tarhoosier
Posts: 182
Joined: Aug 2006

Vasco, as you no doubt know, ng/dL is the common measure of T here in the US. In some parts of Europe it is nmols and, apparently in your corner of Europe (smile) it is ng/mL.

tarhoosier
Posts: 182
Joined: Aug 2006

duplicate

tarhoosier
Posts: 182
Joined: Aug 2006

duplicate

DougS
Posts: 11
Joined: Dec 2011

I have also been on a one year (March, 2011) vacation from Luprone. Although my PSA is currently not as low as yours, it is not above the nadir limit from the previously low value of 0.21.
It is great to be off the meds for a while. ENJOY......yes, smell the roses!

JJPhare
Posts: 34
Joined: Apr 2011

Congrats and huzzah on your achievement and may you remain at this and lower levels.
I am a simple man originally from Indiana (and a Purdue Boilermaker to boot) and have appreciated your informative posts since I was dx'd. Perhaps it was explained before, but why did you need to get T readings and is that something I should seek from my oncologist?

hopeful and opt...
Posts: 1332
Joined: Apr 2009

I am very happy for you. I wish you the very best.......enjoy the moments......I'm sure that there are better ways to communicate my feelings.......but please receive my best thoughts for you.

janekirstine
Posts: 24
Joined: Nov 2010

That is wonderful, VGama!

Thank you for making me dig deeper into testosterone level understanding. I thought my husbands levels were just not getting as low as they should when reading 24 and <10. I knew that our units were ng/dL and had assumed that European results were also given in ng/dL.

With every test the chart below is included with the results:

Total Testosterone (ng/dL)

Age Male

1-9 years <10
10-11 yrs <10-57
12-13 yrs <10-747
14-15 yrs 33-585
16-17 yrs 185-886
18-39 yrs 300-1080
40-59 yrs 300-890
60+ years 300-720
Tanner Stage I <20 prepubertal
Tanner Stage II <10-149
Tanner Stage III <10-762
Tanner Stage IV 164-854
Tanner Stage V 194-783 adult

Now I know our <10 ng/dL is the same as your <0.01 ng/mL and cannot get any lower.

Hope and pray that all "OFF-Drugs Vacations" are long! J

csnuser
Posts: 5
Joined: Feb 2012

I am new at this site so I don't know what is your stats except what I saw above.
I am surprise or puzzled about your psa.
Is it true that you started the HT, because your psa is 1 ?
Or is this after first test after HT?

What was your initial psa when diagnosed?

Mine was 98 and got up to 143 and gleason score of 8.5.

VascodaGama's picture
VascodaGama
Posts: 1565
Joined: Nov 2010

Some guys have not realized yet that the results of tests given to them may have different units of measurement from those given in other countries. Back in 2000 when doing researches on PCa I got trapped in the confusion because some scientific papers (studies) would show the PSA by their molecular mass (moles). They do that based on the combination of the molecules to identify a single protein. For example, the PSA “contains 237 amino acids, with a molecular mass of 26,079 Da” (DA stands for Dalton or unified atomic mass unit).
The testosterone circulates in the blood bound to proteins; each with a molecular mass which added becomes 288.nmol/L.
I think that all of us should get informed on the matter to avoid errors. Here is an explanation on reference ranges for blood tests by our fellas at Wikipedia;
http://en.wikipedia.org/wiki/Reference_ranges_for_blood_tests

I want to thanks Jane for her table on the different levels of testosterone in males. As Tarhoosier comments above, the results are given differently; in some countries in continental Europe, in Asia (Japan, Singapore, etc.) and South America, are expressed in ng/mL. In USA they use ng/dL but at the neighbouring Canada, Australia and UK the results are in moles (nmol/L).
Here is a reference table in different units;
http://www.keratin.com/ab/ab018.shtml

To respond to JJPhare, I would like to say that I am not a “cracker” on matters related to the Testosterone. I would recommend you to inquire with your oncologist, on his reason for not prescribing you a testosterone test. It could be that the test is not part of his protocol for your case.

Nevertheless, I would recommend you and all our comrades to get tested for future reference. The Testosterone is an anabolic substance that builds up bone and muscle, and interweaves with many of our systems which may affect one’s health. Some doctors even believe that guys with low levels of testosterone are at risk for getting prostate cancer.

In my lay opinion, I find it harder to believe that this test is not included in the traditional list of “do things” when one is diagnosed with cancer. Not even in annual health checkups, but this is a "substance very important not only in males but also in females.
The fellas at Wikipedia describe it well in this link;

http://en.wikipedia.org/wiki/Testosterone

When posting I constantly recommend our buddies on HT to get tested for T and Bone Densitometry (scan) because of the castration status induced by the hormonal drugs. Low levels of T can cause bone loss and a series of other health “hazards”.
Some doctors (typical of urologists) never care for T tests and check the progress of HT treatment through PSA tests, assuming that a rise in its levels indicates hormone refractory (HRPC). However, this may not be the case. One’s increasing PSA could be due to badly administered injections or lack of drugs potency.
By other words, such patient did not get to castrate level and the doctor did not check the drug’s efficacy.

HRPC is classified when there is a constant rise of PSA in a low testosterone environment.
Logically, a plateaued low PSA level (remission) in a rising testosterone environment indicates success in the hormonal treatment and one may stop the drugs to check for “cure” or recurrence, as much as one does in other treatments.

The PSA is also a function of several causes and it should be clarified properly. The ranges on tests are also dependent on the manufacturer calibration of their assays. This has caused substantial differences which lead the World Health Organization (WHO) to standardize its measurements.
Here is a well informed article on the subject;
http://zerocancer.org/education/testing/results/

CSNUser;
I am on my twelve’s year as a survivor of PCa. I had two failed treatments and on my continuing care, I started the hormonal therapy. The PSA of 1.0 (ng/ml) was the trigger threshold used by my doctor to start HT. You can read my chronology of events in these links;
http://csn.cancer.org/node/224641
http://csn.cancer.org/node/215330

Thanks to all of you for sharing this moment with me.

I think I smell Windflowers too. Has spring arrived already?

VGama

Samsungtech1
Posts: 350
Joined: Jan 2011

VGama,
Thanks for the heads up. I really appreciate it. Really hope you enjoy your time off.

Good luck to you.

Mike

djs123
Posts: 102
Joined: Jan 2012

Vgama

I am so happy for you and wish you continued good health.
God bless

PS - You have been a great source of comfort and knowledge to me and I know many others on this site...here's an update on my husbands treatment thus far.
One lupron shot 2.5 weeks ago... along with 14 days of Casodex. In a few weeks he has an appointment to begin prep for radiation and another lupron shot.
short of being dizzy twice while on casodex, has had no side effects.

Thanks for all you do for us. You deserve a nice long holiday!

rch
Posts: 79
Joined: Nov 2011

Vgama
Congratulations!! Please enjoy the well deserved vacation.

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