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Old 03-02-2012, 01:34 PM   #1
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DHT Levels

Irv has gotten all of his blood work results back and all looks good. Even his bone scan came back NORMAL! We were thrilled! His vitamin D levels are good, his cholesterol levels are slightly off but nothing terrible, he isn't anemic and his sugars are good too! His testosterone is 1, with the normal range being between 6 and 27.

My only question is regarding the DHT level. The normal range is between 860 and 3400 and Irv's is 1702. Yet he's on Avodart. I was expecting it to be lower. It's well within the normal range and that concerns me as DHT is more potent at fueling the cancer from what I understand. Is this normal for somebody who's on triple blockade hormone therapy?

Rhonda

 
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Old 03-05-2012, 06:44 AM   #2
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Re: DHT Levels

Hi Rhonda,

That DHT is much above what it should be for a patient on Avodart as part of triple blockade. The units in Irv's version of the DHT test are different from mine, but here's what my doctors and I look for: a DHT of 5 or lower with a reference range of 25 - 75 ng/dL (nanograms per deciliter).

Irv could still have benefited from other influences of Avodart, such as reducing the blood supply to the cancer. However, he may be one of the small proportion of patients who does not get much benefit from Avodart (dutasteride) because of his genetic makeup. I've read that such patients often get the benefit they are looking for by switching to finasteride, the generic version of Proscar.

If extra blood was taken and the DHT test can be rerun, that would be a good idea. A fresh test could also be done. If the initial result is confirmed, then I believe the doctors I have been following would switch Irv to finasteride for his "off-therapy" vacation period from the Lupron and bicalutamide.

Irv has had a fine PSA response, and with good control of DHT he should get a long vacation period, hopefully indefinitely long. The Scholz, Lam, Strum and colleagues team have had an informative paper published about this. Good luck in sorting this all out and getting that DHT down.

Regarding cholesterol, is Irv taking a statin drug?

Take care,

Jim

Quote:
Originally Posted by honda50 View Post
Irv has gotten all of his blood work results back and all looks good. Even his bone scan came back NORMAL! We were thrilled! His vitamin D levels are good, his cholesterol levels are slightly off but nothing terrible, he isn't anemic and his sugars are good too! His testosterone is 1, with the normal range being between 6 and 27.

My only question is regarding the DHT level. The normal range is between 860 and 3400 and Irv's is 1702. Yet he's on Avodart. I was expecting it to be lower. It's well within the normal range and that concerns me as DHT is more potent at fueling the cancer from what I understand. Is this normal for somebody who's on triple blockade hormone therapy?

Rhonda

 
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Old 03-05-2012, 03:17 PM   #3
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Re: DHT Levels

Thanks Jim,

We received Irv's lab report and his DHT is measured in PMOL/L.
I've been doing a bit of investigating and have found this information,

DHT Gravimetric measurement of ng/dl ---> Conversion factor is 0.0344 ---> International system of units - NMOL/L

PMOL/L = 1000 x NMOL/L

Therefore, Irv's DHT is 1.702 NMOL/L

If this information is correct, then I'm guessing that this would be equal to 1.702 / 0.0344 = 49.48 ng/dl...which is still high as I understand it should be less than 30.

I don't know if this is accurate, but maybe you might be able to offer some input. I'm also wondering if, perhaps, the lab erroneously used the women's ideal range instead of the men's because the low number threw them off. If the calculation I've used is correct, then that 860 - 3406 PMOL/L would convert to 25 ng/dl - 99.01 ng/dl...Anyway, I have a call into the lab to give me this information.

Rhonda

Last edited by honda50; 03-05-2012 at 03:25 PM.

 
Old 03-05-2012, 03:28 PM   #4
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Re: DHT Levels

Oh no, Jim....It seems that my calculations might be right based on your numbers...and yours DHT of 5 or less is a lot less than Irv's measurement of 49.5. I think he's going to do a retest for sure. This is disturbing.

Rhonda

 
Old 03-05-2012, 04:43 PM   #5
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Re: DHT Levels

Now I've been thinking about this and discussing it with Irv and we're confused. After about 3 months after he started hormone therapy, his Testosterone was at .6 dmol/L and at the last check, after 1 year of triple blockade hormone therapy, his Testosterone was up to 1. At the first check of his DHT after one year of hormone therapy, his level is at about 49 ng/dl, which is very high. The testosterone level is equivalent to about 28 ng/dl. Those levels aren't very low, yet his PSA is still at .02.

So, if DHT is the most potent fuel for the cancer, what was it about the triple blockade that drove Irv's cancer down? Is there something besides testosterone and dht at work here to drive down the cancer?

I'd love to throw this question at the experts!

All that being said, we will have to get Irv retested, but I have a sneaking suspicion that the numbers are correct.

Rhonda

 
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