Repeating BAT therapy?

[Terje]

Has anyone tried BAT more than once?

I was on BAT therapy for about 7 months (until PSA increased),

I then went on Ketoconazole for about 8 months and now the PSA is starting to go up again.

I was wondering if BAT would work if I went back on that again? Has anyone tried this approach?

Thanks!

Terje

[Tall_Allen]

If PSA increased on BAT, you should not go back on it. The T can be dangerous - the cancer gets supersensitized to T. Docetaxel or Xtandi might be a good next step.

[Terje in reply to Tall_Allen]

Thanks for your kind words Tall Allen!

However, Dr. Leibowitz treats men with super high Testosterone levels and you will see men doing this for many years with fluctuating PSA's.

Increased PSA does not warrant a stop in their protocol.

compassionateoncology.org/v...

Also when I started BAT my PSA did go up during the first 2 cycles and I was quite concerned.

However, a brother on this blog advised me to be patient, the same had happened to him, but then his PSA started going down.

I decided to keep going and indeed the PSA went down on my 3rd cycle.

Since BAT is relatively 'new' I was wondering if anyone had any experience with starting this treatment for a second time. It has been quite a while (8-9 months) since I stopped the Testosterone so it would be interesting to see what effect re-introducing super high levels of Testosterone will do.

[Tall_Allen in reply to Terje]

I think you are asking for trouble basing your therapy on a video on a doctor's website. According to what he actually PUBLISHED in a peer reviewed journal in 2009 (and nothing since), he DID NOT practice BAT (although he might now), he just gave supraphysiological levels of T with unknown success and failure.

onlinelibrary.wiley.com/doi...

He reported on 96 patients who received very high dose testosterone replacement therapy (TRT) AFTER some kind of prostate cancer treatment. For 59 of those men, the only treatment had been androgen deprivation. 12% were detectably metastatic. 60% had PSA progression while on TRT, but few had metastatic progression in that time period. For most of those, discontinuing TRT reversed the PSA progression. He discontinued TRT in everyone with rising PSA.

I think you should not make up your own protocols. Indeed, taking T may be dangerous and should really only be done in the context of a clinical trial (like Denmeade's) where you would be closely watched.

As castration resistance sets in, the cancer gets super-sensitized to androgens - even the smallest amount can activate the upgraded androgen receptors. Recall that BAT caused no regression of disease in 64% of men with mCRPC.

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

[dave100 in reply to Tall_Allen]

In reading the referenced article it strikes me as a matter of balancing the BAT phases to keep the aggressive portion of your PCA cell population in check. The rise in PSA can be attributed to the stimulation of the less aggressive population while killing off the more aggressive members. Returning to the castrate state then decimates the less aggressive side again hence the PSA reduction. It's less of a "curative" strategy than a simple preservation of your status quo. Run the ADT phase until PSA begins to rise and then enter the Hi T phase for 3 cycles and return to castrate level and re-check PSA. Repeat until PSA fails to drop with bicalutamide, abiraterone, enzalutamide etc.