At what T level does PSA act independent of T, after SRT

I'd guess that once you are off of ADT for a bit, if your PSA doesn't start rising then SRT worked.

Or PCa wasn't restricted to the area radiated.

Thanks Jack. Your second paragraph is exactly how I understood Morganthaylers saturation theory. And if what you say is true , then my PSA of <.05 DOES carry weight, since my Testosterone is 97, obviously, considrably higher than 50.
That still leaves the question of how my T went from 4, to 149 and then down to 97.

Physically Jack, no. But I have to admit I was mentally deflated. But it is what it is. I’ll take the “<“ with a big smile no matter what the circumstances. So thanks.

CJ, not really. This study determines that once a certain level of T is available to the cancer a higher level of T will not feed it more and cause more growth. In other words, the cancer can only use a certain level of T before it is saturated and can’t use any more.

Your situation is how long should I deprive the cancer of T in order to starve it to death. When the cancer is starved of T it will basically begin to hibernate and thus give of no PSA because it is not actively growing and dividing. ADT susceptible cells will die after some time of starvation, but resistant cells can rejuvinate once the ADT stops and the T recovers. The question of how long must the cancer be deprived of T before it dies has been studied many times. Docs are looking for the ideal balance of T deprivation with quality of life and potential damage from long term ADT. Nine years ago when I was treated, the best study was the BOLLA that indicated ADT should be for 18-36 months depending on the risk level. I received 36 months. At the time some docs were experimenting with intermittent ADT particularly in intermediate risk men to lessen ADT side effects and delay castrate resistance. Something like one year on then a vacation until PSA started increasing and back on ADT. Then about five years ago a study from the University of Michigan indicated that for intermediate and non-favorable intermediate risk that the ADT period was effective in the 12-18 month and that intermittent was also favorable and that a longer period of ADT didn’t provide more benefit. However, it also confirmed that for high risk the period of ADT was more effective in the 18-36 month time frame.

You are high risk. Thus it is well determined that you will need a longer ADT period in the 18-36 month time frame. It appears the trend is now more like coming off after 24 months as we see fewer men going the full three years. Time will tell if these men do as well as the ones that had 36 months. That you did not exhibit Mets means that you should do at least enough ADT to rid yourself of any cancer before it can spread. You really won’t know how effective the ADT has been unti you are off it, unless the PCa becomes resistant first.

My docs stated that in their experience the PCa is generally worse than the dx shows. Thus they treated intermediate and high risk more aggressively. I followed their lead and am happy that I did. Could I have been as effective with a shorter time on ADT? No way of knowing. You will have to work with your docs and determine hope long you go on ADT. No one can definitively say what will work the best for you specifically.

Thanks for the comments Peter. And thanks fir the study, I’ve saved the link for future reference, hopefully I won’t need it.

I’m am not stressing over the PSA result at all, ill take it at face value and enjoy it while it lasts, hopefully forever.😊. The T fluctuation is not stressing me out , just puzzling and a bit frustrating. We’ll see what the Nurse Practitioner has to say tomorrow at my appointment at the RO’s office