My first month of BAT therapy - Advanced Prostate...

Advanced Prostate Cancer

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My first month of BAT therapy

siness profile image
11 Replies

So here are the figures for my first month on BAT therapy

DAY 1 PSA 5 testosterone castrate level

DAY 5 PSA 9.9 Testosterone 38.9

DAY 13 PSA 19.9 Testosterone 11.8, interestingly ALP dropped to 56

DAY 23 PSA 19.7 Testosterone 5.4

I do not think i will be at castrate level before my next injection but at least the PSA has stopped rising, i was diagnosed with a PSA of 3.6 and the highest it has been prior to starting BAT was 7.2

Before i meet my oncologist on Thursday he has asked my to think about adding in Chemo when the testosterone is at its highest, interesting.

Does anyone have any thoughts

Si

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siness
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11 Replies
jdm3 profile image
jdm3

Interesting. Thanks. I would have expected the T to keep going up, but appears to have peaked after a few days. And, sorry, I don't know the history... why BAT? Were other options ruled out?

Tall_Allen profile image
Tall_Allen

You are reporting testosterone in nmol/L? (You must be in Europe then.) And it looks like you are still hormone sensitive. High levels of testosterone and other androgens may induce damage the cancer cell's DNA. One of the interesting hypotheses is that combining high testosterone combined with a chemotherapy that is known to cause DNA damage will be particularly effective. When they began the BAT trial at Johns Hopkins, they used a kind of chemo called etoposide. They found it to be very toxic and eliminated it from their protocol. it is unclear whether docetaxel would be better, but if you have already used it and tolerated it well, it may be worth a try. Testosterone stimulates red blood cell production, which may help prevent their loss due to chemotherapy.

siness profile image
siness in reply toTall_Allen

Thank you Tall_Allen for your reply

Yes i am in the UK, my testosterone in US

DAY 1 PSA 5 testosterone castrate level

DAY 5 PSA 9.9 Testosterone 38.9.... 1121.04 ng/dL

DAY 13 PSA 19.9 Testosterone 11.8....., 340.06 ng/dL

DAY 23 PSA 19.7 Testosterone 5.4...... 155.62 ng/dL

After 3 PSA increases whilst on Zoladex and Zytiga my oncologist said i was Hormone resistant, after 5 years of treatment BAT seemed a good choice at the time.

Tall_Allen profile image
Tall_Allen in reply tosiness

Thanks for translating for a provincial Yank ;-) So you are still taking Zoladex+Zytiga. How did the month of testosterone feel?

siness profile image
siness in reply toTall_Allen

Zytiga was stopped prior to starting BAT it really was not as I expected urine flow dropped dramatically for about 10 days all muscles in the legs ached again for about 10 days and there was me thinking I would be full of energy how wrong can you be

My main concern is as there is little knowledge of this treatment in the UK are my figures are what should be happening my thinking was that I should be castrate after about two weeks to give the psa time to drop think I will just have the second injection and see what happens it can only go wrong 🙁

Thanks again

Tall_Allen profile image
Tall_Allen in reply tosiness

Fatigue is the #1 side effect of Zytiga. The way it worked in the Johns Hopkins trial is everyone stayed on ADT throughout. But every other 28 days they received a supraphysiological dose of testosterone. They repeated until there was progression, meaning PSA continued to rise while on ADT or new mets appeared:

pcnrv.blogspot.com/2016/09/...

clinicaltrials.gov/ct2/show...

Cmdrdata profile image
Cmdrdata

Sinless, can you share the BAT protocol plan that you are having? My understanding is that it is alternating T from castrate level to very high as well as taking Casodex or Zytiga. What drugs are used to cause chemical castration and to raise T level? How many cycles will you be subjected to? Etc.

siness profile image
siness

Hi I am on 3 monthly Zoladex and i have a 400 mg injection of testosterone every 28 days, i see my Oncologist later today for my second injection (maybe)

I am having this treatment in the UK and it is new to my oncologist so we are going at it a bit blind

siness profile image
siness

Update on my latest bloods during my testosterone treatment;

DAY 1… PSA 5 testosterone castrate level, 400mg testosterone injection

DAY 5… PSA 9.9 Testosterone 1121 ng

DAY 13… PSA 19.9 Testosterone 340 ng, ALP 56

DAY 23… PSA 19.7 Testosterone 155ng

Day 28… 400mg testosterone injection

Day 41… PSA 25.96 Testosterone 380 ng ALP 83

sedgley profile image
sedgley

Hi Siness

Any update on your BAT figures or experience please?

nobaday profile image
nobaday

Have u any updates of your BAT therapy

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