Had radical prostatectomy done. On lupron. Getting weakness, shortness of breath. How to increase testosterone level?

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Posted on Wed, 22 May 2013 in Cancer
Question: Hi, I am a 72year old that had a radical prostatectomy when 55. Currently on Lupron six monthly and PSA level is down to 4. My Problem is Testosterone level is 0.9 which leaves me short of breath and no energy. Question, can I go on to a testosterone product to get T level up. XXXXXX
doctor
Answered by Dr. Indranil Ghosh 48 minutes later
Dear XXXXXXX
Thanks for your query.
Before giving my views I need to know a few things. What was the stage of cancer when you were detected? Was there any spread to other sites like lymph glands, bones, etc.
If not, then we do not give lupron for so long.
If there was, and it is in control for long, then we should continue it. But we can make it intermittent , to improve your energy.
If you are taking lupron then testosterone should not be taken as it would counter the effect of lupron.

Hope I have answered your query. Please feel free to write back with your followup queries, if any.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh 1 hour later
Hi Doctor,
To answer your question and give you further details.

When I Had the radical prostatectomy in1995, it had not spread to lymph node or bones. From 1995 to 2001 psa was virtually undetectable until it reached 1.7 in 2002. At that time I had six weeks of radiation treatment which dropped psa to 0.7
Psa remained at that level for about 2 years before it started to climb again. Bicalutamide 50mg was initiated late 2004 and controlled Psa until until 2009 when it started to climb again. Bicalutamide was stopped and had no therapy for 18 months in which time psa settled down to about 0.9. July 2010 decided to try Testosterone cream when PSA started climbing again. Cream worked until July 2012 keeping psa low, and then started to climb again. At that stage Testosterone therapy stopped and Lupron Injections started which I am still having. While on the testosterone quality of life was really good. With Lupron I have become moody depressed at times and do run out of energy. PSA level is currently 4 and that is why I have wondered if there can be a balance between Testosterone level and PSA level. Hope you will be able to advise, Thank You
XXXXXX
doctor
Answered by Dr. Indranil Ghosh 40 minutes later
For you, one option is the imtermittent androgen deprivation (eg, lupron 6 months on then 6 months off). This has almost similar effects to continuous therapy. Quality of life may be better. I would not recommend testosterone therapy.

For mood changes, psychiatric and behavioral therapy may be appropriate.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1513 Questions

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