About 2 months ago I reported my experience with self administered BAT. (search DIY BAT). To summarise I had been on ADT (zolodex) and bicalutamide. When bicalutamide failed after a year (peak PSA 4.4, doubling time about 2 months), I stopped bicalutamide, waited a month to let it wash through, then started monthly intramuscular injections of testosterone (T) cypionate (400mg) while remaining on zolodex. T cycled from a supraphysiological spike to near castrate each month. PSA declined to under 3 and started rising after about 8 months of this regime (peak 3.9). Then I stopped the T and re introduced the bicalutamide. One month after, PSA was 1.8. That was when I wrote the report. This report relates to the next 2 months. PSA declined to 0.85 the next month and 0.55 the month after, a fairly convincing reversal of resistance to bicalutamide. In fact, this response was much better than the original response to it. This is interesting because all trials so far have shown a generally weaker and shorter resistance reversal but none of those involved bicalutamide. It remains to be seen how long my particular resistance lasts but as it stands I reckon I have gained at least an extra year. I intend to repeat the experiment when resistance sets in again.
One of our number, bigdon also recently reported similar experience, also with bicalutamide (see: Final report on BAT after 20 months)
There is food for thought in the BAT story and any means to reverse resistance to treatment is of interest. It is not a magic bullet. Our problem is that there is no incentive for big pharma to fund large scale, definitive trials. We have to learn as we go. Discussion groups like ours pool our ideas and experiences and can come up with much more than any sum of single contributions. We are an idea and experience multiplier.
We are all in the risk analysis game. All treatments have consequences at our stages. We have no option but to devote a lot of attention to risk analysis. I approached this experiment with great trepidation, acutely aware of all the things that could go wrong, and vividly portrayed by my respected, concerned medical advisers. Coming out the other side, testosterone seems to me, if dealt with sensibly, with good medical advice, a fairly straight forward treatment management option. There is much we do not know and in many of our cases, not enough time left to find it out. One principle of risk analysis that occurs to me is that we should limit exposure until more is known. By this I mean that BAT gives a much more limited exposure than continuous supraphysiological testosterone and I prefer it for that reason. Current knowledge would seem to indicate that traversing that interval of blood testosterone concentration that PCa prefers (low-normal) should be minimised. Hence the ADT to cause a precipitous decline after the testosterone peaks. And you go castrate very quickly if things go wrong.
So I am not yet a fan of continuous testosterone. I do not believe that patches and gels can generally get you to true supraphysiological levels (about twice the highest level of the normal range) and only intramuscular injection will get there.
Thanks for being here folks.