Castration Levels and ADT

What is the proper target level for your testosterone to be considered castrate when you are on ADT?

The primary goal of hormone therapy (ADT) is to remove as much of the testosterone from your body as possible to weaken your prostate cancer.  Prostate cancer needs androgens, primarily testosterone to grow and strengthen, first-line hormone therapy (ADT) is used to stop or reduce the production of testicular androgens.

To evaluate the effectiveness of ADT, we measure the levels of testosterone in the blood; historically our goal is to get the levels below 50 ng/ml.  Fifty ng/ml (50) should be considered an old value.  Oncologists who specialize in the treatment of advanced prostate cancer recognize the fact that you want to be at least 20 ng/ml or below to have full and the most effective clinical benefit afforded by castration.

The data from Moretti and also from Perachino  as well as the results of some Canadian data which included six to seven hundred men (600-700) who were on ADT for at least six months showed quite clearly that if you reached a castration level between 50 and 35, you did worse than if you reached a level between 35 and 20. And the group of men who did best regarding survival was those who got down below 20 ng/ml.  

Ask that your doctor regularly monitors your testosterone levels to be sure that you reach the ultimate goal, having a testosterone level below 20 ng/ml.  If you fail to achieve this goal, ask that your doctor switch your treatment to another alternate drug or treatment modality 

 The lower you can go, the better.

This post is written by Joel T Nowak, MA, MSW.