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Old 09-25-2010, 10:50 AM   #1
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Triple Hormone Blockade: When will I be back to normal?

I had a year of the triple hormone therapy in conjunction with IMRT and bracyhtherapy. I asked the clinic when I might possibly develop a libido again and get back a little more energy. My blood work of recent showed a testosterone level of about 30. The nurse at the clinic said I shouldn't expect anything much for at least 18 months, maybe as many as 24. Any opinions on that?

 
Old 09-26-2010, 05:46 AM   #2
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Re: Triple Hormone Blockade: When will I be back to normal?

Hi bwhitney,

Well, you don't need to visit the deli counter at the grocery because you've already been served your baloney quotient for the day! So many doctors and their staffs are truly ignorant of the finer points of hormonal blockade that matter to us. I'll insert some comments in green below.


Quote:
Originally Posted by bwhitney View Post
I had a year of the triple hormone therapy in conjunction with IMRT and bracyhtherapy.
The experts in triple hormonal blockade have had a lot of experience with men on blockade for around 13 months to a year and a half, and your experience was a bit shorter than that, so you would tend to do better in recovery.

Quote:
I asked the clinic when I might possibly develop a libido again and get back a little more energy.
Did you do aerobic exercise and strength training (resistance/weights) while on blockade? Many of us don't, but those exercises will maintain energy and muscle (!) for most of us. I've been on full therapy three times now, and have done aerobic exercise all three times, succeeding in maintaining energy and avoiding fatigue (except for minor fatigue the first few months) each time. The second and third time I was on a strength exercise program, and I was actually able to increase my upper body muscle mass slightly. (Lower body muscle mass is less of a problem for most of us; it was never an issue for me. My testosterone was <10 at its lowest point on this latest (third round), and it was about 20 on the second round, and slightly lower on the first. Testosterone is a huge help in maintaining energy and strength, but it is not essential, though there are many medical professionals who mistakenly think that it is.

Did your doctor advise you about the importance of exercise?



Quote:
My blood work of recent showed a testosterone level of about 30.
How long was that after your last shot, and how long was the shot supposed to last? My testosterone had risen to 200, obviously recovering but still below the normal range, and was clearly continuing to climb in mid-August, the four month point after the shot "ran out" in mid-April after this third round. I'm now confident it is in the normal range. For all three rounds of blockade, it has taken me four to six months to recover, with partial recovery by the third to fourth month, but full recovery by the sixth month.

Quote:
The nurse at the clinic said I shouldn't expect anything much for at least 18 months, maybe as many as 24. Any opinions on that?
You might want to give her a copy of "Invasion of the Prostate Snatchers," the new book that does superb job covering so many issues important to prostate cancer patients, but especially hormonal blockade. The medical co-author, Dr. Mark Scholz, is one of the experts and leaders regarding triple blockade, especially intermittent or one-course triple blockade. There are about a dozen pages in the book that discuss aspects of testosterone recovery.

Generally, per Dr. Scholz, "Taking TIP [mean hormonal blockade] for a year is a considerable undertaking. After the treatment is stopped an additional three to four months are needed for the body to regenerate testosterone. Generally life reverts to normal as long as appropriate preventative measures are followed during treatment." pp. 149-150 My impression is that the vast majority of us will at least substantially recover testosterone in that time, even if countermeasures were not taken during treatment, though there may be some other consequences without countermeasures, such as a degree of penile atrophy. I believe I was slower to recover T because my times on blockade were well over a year: 31 months for the first cycle and 19 months for both the second and third cycles.

The book also makes the point that about 25% of us have some degree of permanently decreased libido. The flip side of that is that the vast majority of us - 75% - fully recover libido. It took Mr. Blum, the non-medical co-author (Dr. Scholz patient), 7 months to recover T substantially, but he was in the group that did not fully recover libido. Mr. Blum writes on page 89: "... recovery depends on such variables as a man's age, the type and length of hormone treatment, his life circumstances and a variety of psychological factors."

I've read and heard numerous times that recovery is decreasingly likely as a man is on blockade for more than two years and is over age 70. My strong impression is that being on blockade for just a year makes recovery of testosterone a very strong probability.

I hope this helps.

Take care,

Jim

 
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Old 09-26-2010, 08:24 AM   #3
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Re: Triple Hormone Blockade: When will I be back to normal?

Once again I find myself indebted to you. Thanks for the info. I will look for the book by Shultz.

My last injection was in April, and I think it was a 4 month shot. As far as exercise, it was explained to me the importance of exercising, which had always been a party of my life. I did what I could. I suppose I could have done more. My job as a painting contractor keeps me moving. I am very much "hands on" with the work. At the end of the day, I don't have a lot left in the way of energy. At age 62, I realize I am beyond my prime. I have no illusions there.

My testosterone level was checked in mid-july. If I read you correctly, I might have hopes of seeing a rise in that level, as well as my libido in the next couple of months. Unless of course, I fall in with the 25% group. My next blood work is scheduled for mid-Dec.

I realize the importance of the Triple Blockade, esp. with the high risk cancer I had. Just out of curiosity, are testosterone supplements anything to be considered, or is that jumping back into the fire?

While I have your attention, Jim, the BM thread I posted is an issue that really is a far bigger concern to me right now. I have some rough patches were continence is an issue. I hope that can improve with time. My last radiation was in the last part of Dec. My mornings can be totally screwed up. I am afraid to leave the house sometimes Diapers I don't even want to think about. I don't know if I could go there.

 
Old 09-27-2010, 06:23 AM   #4
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Puzzled: Relationship of T and PSA levels ?

IADT3since2000 stated: (Quote) Testosterone is a huge help in maintaining energy and strength, but it is not essential, though there are many medical professionals who mistakenly think that it is (EndQuote)

Jim,

Out of ignorance I have always considered testosterone and PSA as interchangeable terms; that is high readings of both = , and low readings in both = . From your comments, I gather this isn't the case at all

I seek clarification: Is it possible for both PSA & Testorone levels to move independently? Said another way: Can PSA levels be (optimally) low and testosterone (optimally) levels high at the same time? If so, what kind of HT, diet, exercise, supplement program makes this possible?

Thanks in advance, Mitch

 
Old 09-27-2010, 03:21 PM   #5
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Re: Triple Hormone Blockade: When will I be back to normal?

I'm replying to post #3 from bwhitney. Hi again, and you're welcome. You wrote,

Quote:
....

My last injection was in April, and I think it was a 4 month shot. As far as exercise, it was explained to me the importance of exercising, which had always been a party of my life. I did what I could. I suppose I could have done more. My job as a painting contractor keeps me moving. I am very much "hands on" with the work. At the end of the day, I don't have a lot left in the way of energy. At age 62, I realize I am beyond my prime. I have no illusions there.
Yes, being one's prime helps a lot. However, I've been very pleasantly surprised with the fitness us older guys and gals can achieve if we invest in exercise and diet. I'm now leg pressing over 300 pounds, about double my weight, for instance. I'm not training for racewalking as I once did, but I'm confident I could get my time for a mile to well under 12 minutes if I tried. Not bad for a 67 year old. My results are by no means unique to me. But it takes work! (And time - a problem for many of us.)

Quote:
My testosterone level was checked in mid-july. If I read you correctly, I might have hopes of seeing a rise in that level, as well as my libido in the next couple of months. Unless of course, I fall in with the 25% group. My next blood work is scheduled for mid-Dec.
Yes, that's correct. I want to add a point about that 25% group. A lot of us on triple blockade continue with Avodart or finasteride as maintenance, and those drugs have interesting libido effects. For about 80% of us the effect is favorable; by virtually eliminating conversion of testosterone to DHT, we get more testosterone, and that is nice! However, about 20% of us (10% on placebo too, 10% apparently a real effect, so hard to tell if the true number is 10%, 20% or somewhere in between) have decreased libido and sometimes a degree of ED. That 20% may account for much of that 25% group, but I'm not sure about that.


Quote:
I realize the importance of the Triple Blockade, esp. with the high risk cancer I had. Just out of curiosity, are testosterone supplements anything to be considered, or is that jumping back into the fire?
No, it may not be jumping back in the fire, but it could be. Two of the leaders in triple blockade, quite independent of each other (to put it mildly) are Drs. Robert Leibowitz and Dr. Mark Scholz. Dr. Leibowitz has for a long time been suggesting carefully done testosterone replacement for appropriate prostate cancer patients who are recovering from hormonal blockade with unduly low testosterone. Dr. Scholz has also been using testosterone replacement for such patients. However, I'm not sure if either or other leading doctors have ever tried it with patients who were or had been metastatic; that used to be forbidden territory, and I do not know if that has changed. Short of documented metastases, my impression is that it's game on; but remember that I'm a layman with no enrolled medical education. Obviously, PSA is monitored with extra diligence for such patients.

Quote:
While I have your attention, Jim, the BM thread I posted is an issue that really is a far bigger concern to me right now. I have some rough patches were continence is an issue. I hope that can improve with time. My last radiation was in the last part of Dec. My mornings can be totally screwed up. I am afraid to leave the house sometimes Diapers I don't even want to think about. I don't know if I could go there.
That's from radiation, right? That could be super bothersome, but I'm afraid I don't know much about that problem. If it's mainly looseness, reducing fiber in the diet (normally higher fiber is healtheir) and adding some refined starch (like white bread), plus cheese ("binds like cheese"), neither normally on the good side of our lifestyle tactics as survivors, might help. So will thalidomide, which will also help with the cancer, but that's a whole different story.

Take care,

Jim

 
Old 11-08-2010, 01:02 PM   #6
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Re: Triple Hormone Blockade: When will I be back to normal?

How do you guys recover from a triple blockade? yet finasteride alone can **** up guys.

 
Old 11-08-2010, 04:24 PM   #7
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Re: Triple Hormone Blockade: When will I be back to normal?

Quote:
Originally Posted by Dilla87 View Post
How do you guys recover from a triple blockade? yet finasteride alone can **** up guys.
Slowly, apparently. I was on it for a year. It has been since July that my last injection should have worn off. I have less energy now than ever. I am dealing with some other post-treatment issues as well such as an ulcerated colon and some urinary distress. I had blood work done last week to check my T-level. I should know tomorrow. Last checked it was >30. I hope it has increased. As you know everyone responds differently. Jim answered my question quite well if you check for that. Best of luck.

 
Old 11-09-2010, 03:24 PM   #8
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Re: Triple Hormone Blockade: When will I be back to normal?

Quote:
Originally Posted by Dilla87 View Post
How do you guys recover from a triple blockade? yet finasteride alone can **** up guys.
Got the results of my bloodwork back. My testosterone level has gone from >40 to 4. No wonder I am feeling so tired all the time, lacking energy and anything approaching ambition or motivation to do anything, not to mention libido.

 
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