How do you approach a patient with a non-castrate testosterone level and rising PSA despite receiving LHRH agonist therapy?  

This is a good question. It is always good to check on the testosterone value in men on LHRH agonist therapy in order to ensure the level truly is within castrate range. I assume this patient has been on therapy for a number of months (i.e. the testosterone has had time for full suppression). If so,...