Androgen blocker Vs ADT

[kaptank]

Seems to be suggesting go to (eg) bicalutamide monotherapy before ADT. Seems a good idea to me, but everyone is different.

practiceupdate.com/C/77171/...

[pjoshea13]

A few years ago I was rather surprised to come across Casodex as monotherapy. I knew no-one in the U.S. doing that. But I was told that it's not uncommon in Europe.

The great attraction is that one can maintain testosterone [T] levels & avoid castration-related morbidity, such as the metabolic syndrome [MetS], at least for a while. Of course, many men with PCa already have low T & MetS symptoms.

I suppose that if I had been more aware, I might have gone that way & added Avodart to limit DHT, which is the problem androgen. I would have continued to balance the T:E2 (estradiol) ratio with T supplementation & Arimidex.

-Patrick

[Ran2599dy in reply to pjoshea13]

How many men also add Metformin? My prescription calls for 1000 per day.

[pjoshea13 in reply to Ran2599dy]

In the 2014 Swiss paper that so impressed Dr. Myers (& me too), 2,000 mg was used. I mentioned the study to my integrative medicine doc & he agreed to up my dose (from 1,000 mg.)

ncbi.nlm.nih.gov/pubmed/244...

-Patrick

[kaptank in reply to pjoshea13]

I have been on 2000mg metformin for many years. That is about the max safe dose. My doc thought it made sense to control insulin/sugars as a long term plan.

[EdBar in reply to kaptank]

Same here per Dr. Myers, 2000mg per day, been taking Metformin for about 4 years now.

[kaptank in reply to pjoshea13]

We are all learning as we go. Its terrific to be able to learn from each other with this forum.

[dockam]

After I got my MO to let me stop Lupron after 30 months with last one on 03/31/2017, I asked to be on 150mg Casodex/day and he allowed it. T got to 1002 and PSA to 10.2. Also on Metformin 2000mg/day. Just had Lupron shot and maybe if T gets < 20 and PSA goes undetectable, I'll go on a hormone holiday once more. Fight On

[kaptank in reply to dockam]

Let us know how that goes. An ADT holiday would be nice...

[Hidden in reply to dockam]

Please, give us updates, as most doctors don't want vacation failures on their watch...

[cesanon]

I think the wisdom is to hit it hard with everything at once as opposed to slowly escalating (step therapy) the treatment.

[kaptank in reply to cesanon]

Here in Australia the wisdom in the past was step therapy. That is changing I think. I was always a fan of the "chuck everything at it" school. I am rethinking that as we learn more about cross resistance and treatment induced mutations and other changes. We are certainly dealing with a very tricky critter and our ignorance is profound.