Oncology (General Cancer)/metastasis prostate cancer

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Question
QUESTION: I have/had prostate cancer stade 3.
My therapy was radiation, resection of lymph nodes and hormone therapy.
Hormone therapy was for 2 years and ended March 31.
I have/had a lot of symptons: depression, hot flashes ...
Depression has ended.
However hot flashes not. I have the impression they are now more severe then before.
How long does it takes to have all symptoms disappeared? How long does it takes to have normal testosterone levels?
THx.

ANSWER: I don't know how old you are, but it's possible you won't have return of normal testosterone levels.  Hormone therapy eventually results in "involution" of testicular tissue, which means that the cells which form testosterone essentially die.  This is more common the older you get.  Most doctors would not give you a testosterone supplement, which would take away your symptoms, but may increase your risk for more problems with prostate cancer.  (I don't believe that myself, because after radiation therapy or surgery, there isn't any prostate tissue left to react) but that's the state of medicine.  Another excellent way to deal with hot flashes is to go on drugs from the class called "SSRI" -- selective serotonin release inhibitors.  They also can help with depression.  Of course if you are only a month or so from having stopped the hormone suppression, you may find things evening out with a little more time.  If you are still bothered after six months I'd consider drug therapy.  Hope this helps.  

---------- FOLLOW-UP ----------

QUESTION: Thank you for your answer.
I'm 67 years old.
I have another question.
My PSA is now <0.03. This is excellent.
However cancer may come back after several years.
My question is now: where are the cancer cells may be hidden. How they survive?
If you have a relapse f.e. after 10 years where were the cancer cells during these 10 years?

Answer
First, there are other tissues in the body that make PSA.  Yours is now in the "normal" range.  However, you could still have a few live cancer cells that may be reproducing very slowly (doubling time in excess of several years.)  If you have any, they could be in lymph nodes or even in the prostate bed.  If you take a population of cancer cells, there may be some that are resistant to everything you can throw at them.  However, you seem to have everything going for you and if the disease relapses in ten years, it's likely we will have a cure for it by then.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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