Cycling T and ADT?

I sure like the concept of Cycling T and ADT to prevent CRPC. Dr. Myers does not use this protocol and when I asked an oncologist at The Mayo Clinic about it, he drew a diagram of PCa, and said it would not work because PCa is made up of many different genetic variants including populations of cancer cells that do not produce PSA.

The protocol makes sense when you think about it but seems to good to be true. If Cycling T and ADT would work by preventing CRPC why wouldn't doing 3 month on/off cycles of Casodex or Xtandi work...would the AR receptors mutate over time...but one fact is for sure ...anything beats continuous ADT with all its side effects the worse being CRPC and a long painful death.

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  • Gus - I agree with that in general.

    The objection that "some prostate cells do not create PSA" seems invalid because

    1. While it is possible and even likely that at some point PC cells will "go dark", it is hardly common.

    2. PSA is still the way, rightly or wrongly, that most Drs base treatment decisions on, so this subset would confound any treatment, not just this one.

    3. This cycling does not depend on PSA levels, so whether cells do or do not produce PSA is irrelevant to the treatment pattern, and this treatment could not be frustrated by the existence of this unusual variant.

    4. The response seems like reflex objection rather than a carefully considered thought, diagram or no diagram.

  • I asked my urologist about this, and he is the dept chair at the leading university research hospital here in Minnesota. He said that there have been three studies on this so far, two of which were inconclusive or showed no benefit, while the third actually showed that the group who cycled had worse result. So, while I think the idea is an interesting one, I don't think we know enough to actually follow this path.

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