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Radiation Oncology • Genitourinary Cancers
What would your approach be in a man currently on treatment for high-risk prostate cancer with ADT who does not have castrate levels of testosterone?
A patient with low-volume but high-risk prostate cancer (Gleason 8 disease) has completed a course of RT and remains on ADT with 3-month depot injections. His PSA is undetectable, but his testosterone is not at a castrate level (≈200). Would you modify therapy or keep things as is since his PSA is so low?
Answer from: Radiation Oncologist at Academic Institution
I would switch to a GnRH antagonist or add another agent.It is perhaps worth noting that most (all?) randomized trials of ADT with RT combined agonists like leuprolide with bicalutamide. Ongoing trials (NRG-GU010, NRG-GU009) still require this. There is an interesting biological explanation for why ...
Answer from: Radiation Oncologist at Community Practice
I would first measure testosterone using mass spectrometry. There's a fair probability in this case that testosterone is already at castrate levels.
Comments
Radiation Oncologist at Kansas City VA Medical Center
Agree with Tony, if available they should consider...
Agree with Tony, if available they should consider...
Agree. The depth of testosterone, even below stand...