Kinetics of testosterone recovery in clinically localized prostate cancer patients treated with radical prostatectomy and subsequent short-term adjuvant androgen deprivation therapy
Dai B; Qu YY; Kong YY; Ye DW; Yao XD; Zhang SL; Zhang HL; Yang WY
Asian Journal of Andrology2013
Summary (paraphrased)
Ninety-five men with localized prostate cancer who completed 9 months of adjuvant androgen deprivation after prostatectomy had testosterone measured at cessation and at 1, 3, 6, 9, and 12 months afterward. Nearly all patients (97.9%) had recovered past castrate levels by 3 months, but only 36.9% had reached normal testosterone at that point; the proportion reaching normal levels rose to 66.3% at 6 months, 86.3% at 9 months, and 92.6% at 12 months. A higher baseline testosterone (≥300 ng/dL) predicted faster normalization. The study establishes that HPG-axis restart after medical castration is a slow, months-long process rather than an immediate rebound.
Why it’s in the systems review
This is the canonical quantitative record of HPG-axis restart kinetics after medical castration: even with only 9 months of ADT, a meaningful fraction of men took a full year to normalize testosterone. It sets the recovery timeline against which post-drug-syndrome persistence can be judged — symptoms that outlast this restart window point to something beyond simple testosterone recovery, which is exactly the logic of Powers' theorizing that persistent central symptoms survive restored peripheral androgen signaling. It also documents baseline testosterone as a recovery predictor, relevant to any treatment-candidate protocol that involves HPG-axis restart.