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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Testosterone Challenge in Men Post-Radical Prostatectomy with Profoundly Low T
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<blockquote data-quote="madman" data-source="post: 223323" data-attributes="member: 13851"><p><strong>Testosterone (T) Challenge in Men Post-Radical Prostatectomy (RP) with Profoundly Low Testosterone (2022)</strong></p><p><em>JFlores Martinez, JPMulhall, SDeveci, KMatsushita, JTorremade, CASalter</em></p><p></p><p></p><p><strong>Introduction</strong></p><p></p><p><em>Prostate-specific antigen is the primary marker of prostate cancer recurrence. PSA secretion is T dependent with T levels below saturation point associated with sub-optimal PSA production. Men with an undetectable PSA level after RP with very low T levels might have an artificially low PSA level.</em></p><p></p><p></p><p><strong>Objective</strong></p><p><strong></strong></p><p><strong><em>We aimed to evaluate the effects of raising T levels in such men.</em></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Methods</strong></p><p><strong></strong></p><p><strong><em>The study population consisted of (i) men post-RP (ii) with undetectable PSA levels (iii) total T levels <200 ng/dl (two levels, LCMS) who (iv) underwent in-office intramuscular injection of 100mg of T cypionate (v) had a PSA level checked 5 days later, and if undetectable every month after that, 3 months later then every 6 months and (vi) follow-up of at least 24 months on T therapy.</em></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Results</strong></p><p><strong></strong></p><p><strong><em>22 men have been challenged thus far. Mean age 62±18 years. Mean preoperative PSA 6.2. Mean post-RP TT value 140± 35 ng/dL 2.2. Median Gleason sum 7. 23% had GS ≥8. Mean post-RP, pre-challenge T value 140± 35 ng/dL. Mean time post-RP to challenge was 7± 9 months. Mean TT value 5 days after IMT challenge 640± 220 ng/dL, all with TT levels above 400. 5/22 has a PSA elevation, 2 immediately after IMT challenge (PSA values 0.07, 0.08). All other men started T therapy immediately and had PSA elevation at 9, 14, and 22 months after commencing T therapy (PSA values 0.08, 0.12, 0.11). All patients with PSA elevation had continued rise in PSA and had detectable disease on imaging. All men with PSA recurrence had either GS 7 with unfavorable pathology (2) or GS ≥8 (3).</em></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Conclusions</strong></p><p><strong></strong></p><p><strong><em>This T challenge approach permits the early detection of prostate cancer recurrence permitting early intervention. About 10% of such men had a PSA rise immediately after T challenge.</em></strong></p><h3></h3></blockquote><p></p>
[QUOTE="madman, post: 223323, member: 13851"] [B]Testosterone (T) Challenge in Men Post-Radical Prostatectomy (RP) with Profoundly Low Testosterone (2022)[/B] [I]JFlores Martinez, JPMulhall, SDeveci, KMatsushita, JTorremade, CASalter[/I] [B]Introduction[/B] [I]Prostate-specific antigen is the primary marker of prostate cancer recurrence. PSA secretion is T dependent with T levels below saturation point associated with sub-optimal PSA production. Men with an undetectable PSA level after RP with very low T levels might have an artificially low PSA level.[/I] [B]Objective [I]We aimed to evaluate the effects of raising T levels in such men.[/I] Methods [I]The study population consisted of (i) men post-RP (ii) with undetectable PSA levels (iii) total T levels <200 ng/dl (two levels, LCMS) who (iv) underwent in-office intramuscular injection of 100mg of T cypionate (v) had a PSA level checked 5 days later, and if undetectable every month after that, 3 months later then every 6 months and (vi) follow-up of at least 24 months on T therapy.[/I] Results [I]22 men have been challenged thus far. Mean age 62±18 years. Mean preoperative PSA 6.2. Mean post-RP TT value 140± 35 ng/dL 2.2. Median Gleason sum 7. 23% had GS ≥8. Mean post-RP, pre-challenge T value 140± 35 ng/dL. Mean time post-RP to challenge was 7± 9 months. Mean TT value 5 days after IMT challenge 640± 220 ng/dL, all with TT levels above 400. 5/22 has a PSA elevation, 2 immediately after IMT challenge (PSA values 0.07, 0.08). All other men started T therapy immediately and had PSA elevation at 9, 14, and 22 months after commencing T therapy (PSA values 0.08, 0.12, 0.11). All patients with PSA elevation had continued rise in PSA and had detectable disease on imaging. All men with PSA recurrence had either GS 7 with unfavorable pathology (2) or GS ≥8 (3).[/I] Conclusions [I]This T challenge approach permits the early detection of prostate cancer recurrence permitting early intervention. About 10% of such men had a PSA rise immediately after T challenge.[/I][/B] [HEADING=2][B][/B][/HEADING] [B][/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Testosterone Challenge in Men Post-Radical Prostatectomy with Profoundly Low T
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