Bipolar Androgen Therapy results? - Advanced Prostate...

Advanced Prostate Cancer

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Bipolar Androgen Therapy results?

oldcars
oldcars

I was diagnosis with a gleason 9 and 900 psa in 2016. I am now on Bipolar Androgen

Therapy. I am new here. My psa has gone from 2500 to 1000. Does anyone have

good luck with it or know of those who had good luck with it?

Thanks,

23 Replies
oldestnewest

Most of the men I have personally known in recent years who have had PSAs that high were multiply metastatic Stage IV and went onto permanent, full-time Androgen Deprivation Therapy, often with added Zytiga & Prednisone, or with added early chemo with Docetaxel. In many cases, these treatments reduced their PSA numbers to much lower levels. Hitting it hard and hitting it early. What's your lowest PSA level been? Do you have any pain symptoms? What have your scans shown? Etc. Have you considered seeking a second opinion from another advanced prostate cancer specialist?

Good Luck and keep us posted.

Charles

I talked to a guy with mCRPC who went through 3 cycles of BAT at Johns Hopkins.

Hidden
Hidden in reply to Tall_Allen

So funny, the look on the faces of my docs when I mentioned BAT. They look at me like I've turned into a vampire.

Tall_Allen
Tall_Allen in reply to Hidden

They are right to be cautious. It may make things much worse in some men. It should not be attempted outside of a clinical trial.

kaptank
kaptank in reply to Tall_Allen

My reading of the Johns Hopkins reports, explicitly stated by Sam Denmeade is that genuine BAT with supraphysiological levels of T has a worst case in 3 months of no effect, PSA ends up where it would be if no T. It takes 3 months to find out and if it fails you are no worse off than doing nothing - and even then rechallenge with anti androgen may well bring a response..

The danger (IMHO) is where physiological levels of T are achieved by skin patches, oils etc. They cannot achieve supra T. Only injection can get there.

There is a lot of misinformation even in text books about T and prostate cancer. Even Huggins acknowledged that supra T may well be as useful as castrate T.

Tall_Allen
Tall_Allen in reply to kaptank

The way I read Denmeade, 36% (n=30) had some regression of disease while on BAT, which means 64% did NOT respond at all. How they would have done is anyone's guess because this was not randomized. There were adverse side effects while on BAT. Transient pain flares was the most common, affecting 40%. Three men suffered serious side effects: pulmonary embolism, heart attack and urinary obstruction. Until they learn how to identify responders and how to identify who is harmed, this should not be attempted outside of a clinical trial.

The current clinical trial in Denver uses transdermal testosterone.

kaptank
kaptank in reply to Tall_Allen

The Johns Hopkins trials screened out symptomatic patients with pain for fear of making the pain worse.The limited evidence is ambiguous on that - there are reports that pain was relieved by BAT and others that it made it worse. We are nowhere near being able to identify responders. A couple of super responders had BRCA2 and ATM mutations but that's it. There is no institutional incentive to find out. Big pharma has no interest. My reasoning was that in the absence of any test to identify responders, for an individual, the most accurate and cheapest way to find out is just to do it, carefully monitor, continue ADT and be ready to abandon BAT when adverse PSA trend arises - then rechallenge with anti androgen.

There is a huge amount of info about Supra T in the weightlifting/body building communities.

Rkoma
Rkoma in reply to Tall_Allen

If we talk about the same trial here are some facts:

9/30 achieved more than 50% PSA reduction during BAT.

17/30 achieved any PSA reduction during BAT

21/30 did Enza re-challenge

15/30 achieved PSA reduction more than 50%

19/21 achieved any PSA reduction during re-challenge

14/30 proceeded with chemo after progression. Median fir chemo start was 20.4

Despite of low number of grade3-4 AEs I agree with TA that this should only be done as part of a trial ( or under supervision of BAT experienced MO)

Regards

Rkoma

podsart
podsart in reply to Tall_Allen

Anyone tried Supra hi continuously together with xtandi without lupron?

I used it against advice. 8 months BAT resensitised my cancer to bicalutamide for another 6 months. Effectively doubling the usefulness of bicalutamide and bringing me to a PSA about one third of my starting point baseline.

Nalakrats
Nalakrats in reply to kaptank

I read the initial results of Demeade's work differently. i remember 30-35% having PSA reductions of over 50 %. About 30 % had no further increase in PSA--it stopped it dead, in its tracks, the rest did progress. 2, or 3 had severe Heart Issues, and I think 2 died. It was determined later they were going to die of Heart Disease anyway. And there was a claim of 2 cures. This was from the original work done in England before Demeade took it in house at John Hopkins. 67 patients were involved. Though crude in its design, it is still crude. As there is an obvious benefit, some would say a major benefit for a certain population. And for others there is not. Allen states that there needs to be a way to identify those that would benefit---I agree. I am just amazed, that the first thing that was not done, was to divide men according to Gene Mutations, AR-V7 activity, and Pathologies. Yes this would be multi-pronged and take many years.

I am a personal fan of BAT, and I would DIY myself if I thought I needed it, as I have an endless supply of Testosterone Cyprionate and a retired Nurse wife who gives great injections. I have read every book on T over the last 20 years, and was on T replacement for 23 years before my Pca DX.

As to using it for resensitizing for Xtandi, or Casodex, or Zytiga, we know it works for some-- but no studies, have been done; but it appears it is positive in the low range, probably 20%. If you find out why some can be re-sensitized, you will probably answer, who are treatable with positive results. I personally know 2 men, one has been doing the DIY BAT for 7 years, and another about 12 years.

Without getting into details, they go from Injection, giving them an undetectable PSA, to 30 days later to having a PSA of over 20--and they yo yo back and forth every month for years.

Demeade was not close to being first. I have results from a Urologist in Colorado, who has been doing this all the way back to 2008--he uses other materials along with the injections. Something to modulate Estrogen.

Anyway, without congratulating you on your protocol, I am up-lifted by what you are doing.

Nalakrats

Old cars

1. How much testosterone are you taking.

2. What we're and are your testosterone levels.

3. Where are you getting the treatment from

Thanks

oldcars
oldcars in reply to cesanon

I get 400 mg. injection. I am 79. I am In the San Francisco ,CA area. I am not

treated by them, but Drs. at Hutch Center in Seattle ,WA. treat ,I belive. I am

All thumbs on the computer.I should consult with my Doctor about the rest.

Psa is 756 they say now. No scan since starting B>A>T>.

teamkv
teamkv in reply to oldcars

Would you be so kind as to tell me who are the doctors you are working with in Seattle? Husbands PSA has just started climbing on Lupron. Lowest point 2 months ago was .34, then it went to .38 now yesterday at .54. We are getting ready for radiation. Not sure if this new turn will change that or not.

cesanon
cesanon in reply to teamkv

Mine can zig zag like that between 0.50 and 0.85

It took a while to accept that it was not in fact increasing....at least at the moment.

teamkv
teamkv in reply to cesanon

Okay. That is really good to know. Thank you, thank you. At least it’s not a definite.

oldcars
oldcars in reply to cesanon

I am Getting 400 mg. of Testosterone per shot. My Doctor is Dr. Wes Lee of

St. Joseph's medical Hospital in Santa Rosa , CA. I no longer take Etoposide.

cesanon
cesanon in reply to oldcars

Oldcars, how long have you been taking testosterone? What is your testosterone level?

How has is affected your PSA?

oldcars
oldcars in reply to cesanon

I do not Know my T level. I started Jan 12,2019. Psa dropped from 1300 to 650 about.

cesanon
cesanon in reply to oldcars

Oldcars, are you happy with the result? Happy with the decision?

Would you be kind enough in a future post tell us your age? where your'e located? Being Treated? and Doctor(s) names(s)? all info voluntary. Please do not respond to me.

The info you provide helps us help you and the info helps us too. Thank you.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/26/2019 11:07 AM EDT

I’m participating in a high T clinical trial out of Denver. It’s not BAT; but seeks to maintain high T and uses the gel (100 mg/day). My T is near 1000. I’m going into week 5. Last week my PSA was up from the start of the trial 4 weeks ago (from 20 to 32), but the rate of change slowed way down. It was doubling about every 2 weeks prior to the start. Potentially it could have been closer to 80 without the high T. Next weeks labs will likely be a decision point for me - but scans results are probably more important for my decision than PSA. Not sure if it’s working, but it sure feels good to have high T.

How did it go on this BAT? And new results? Thanks!

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