New Denmeade paper, but free Abstract lacks details.
"Bipolar androgen therapy (BAT) is a paradoxical treatment for castrate-resistant prostate cancer whereby testosterone levels are rapidly alternated between supraphysiologic and near-castrate concentrations. Initial studies demonstrated that BAT is safe and produces clinical responses. A trial comparing enzalutamide against BAT is ongoing."
I suppose that I bristle a little when I read "paradoxical" & "supraphysiologic".
It is well-established that ADT causes CRPC. In fact, the price of ADT is accelerated aggressive disease. It is Reasonable to think that restoration of androgen might unsettle CRPC cells & perhaps reverse certain aspects of it.
Many men do not acheive "supraphysiologic" levels of T. Far from it. & it is not necessary, it seems. Is 2,000 ng/dL better than 1,000 ng/dL? I haven't seen the evidence. When androgen receptors are saturated with T, how does extra T act?
Since I am on BAT rather that paradoxical I call it counter intuitive. I'm not in a trial, but there is one locally and my doctor also has patients in the trial, but since I had already had both Zytiga and Xtandi, I was not eligible. Before my first treatment my PSA was nearly 5000 and in the last 3 months it has fallen as low as 1670, although it was nearly 3000 last week. More encouraging is the fact that scans last week showed shrinkage in lymph mets, shrinkage and apparent healing in liver mets and no new activity in the bones. I'm having another injection of testosterone tomorrow and continue to monitor PSA and T levels every 2 weeks with the plan to have another injection in early May unless numbers are significantly worse or I begin to have pain or other symptoms.
What interested me is how in some guys BAT reversed CRPC
I wonder about the "medical establishment" embracing this treatment option. Mayo, are you onboard with it? I doubt it. Seems like you need to find a maverick doctor to step out side the established guidelines.
the word is slowly getting out..imo the future of BAT lies in turning off AR-V7 so Xtandi and Zytiga work again...also there is research showing BAT can reverse CRPC even when AR-V7 is not a factor and reverse AR mutation that occurs in CRPC
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