BAT only for CRPC??

[Tommyj2]

Is there any particular reason that BAT could not be used as first line Tx of rising PSA?? Sounds like it could mollify some of the Treatment SE's of standard ADT and still leave time for standard ADT if one is not too far advanced when beginning it....

[FCoffey]

BAT won't contribute to urologists' boat payments.

[tango65]

BAT has been tested in hormone sensitive prostate cancer.:

"BAT demonstrated preliminary efficacy in men with HS PC following 6-month of ADT. BAT may improve QoL in men treated with ADT."

ncbi.nlm.nih.gov/pubmed/273...

[George71]

after initial treatment chemo + ADT for a short period -- Dr. Bob Leibowitz stops everything and puts patients on continuous daily high dose testosterone --- rub on gel -- and nothing else for years. their cancer basically stops progression -- ie. PSA may be 15 and stays 15 for 10 years -- these are stage 4 with extensive mets.

compassionateoncology.org/v...

[Tommyj2 in reply to George71]

Is this a treatment that you have done yourself George??.... Certainly challenges the accepted model.... and frankly makes little sense in terms of what I have learned thus far.... but if it worked who WOULDN'T be happy to go this route.... Haven't watched the vid so these are provisional statements..... thanks for the info.

[George71 in reply to Tommyj2]

Watch the video it is really educational.

Dr. Leibowitz's focus is to keep you from ever getting CRPC.

[Tommyj2 in reply to George71]

Wish the fellow weren't completely across the country from me... I don't have the money to be flying around... Also have to set aside 34 minutes ( which is a big chunk of time in my current researches) to review this entire vid...

[kaptank]

The question is, could BAT be effective as a first line treatment. I am not sure. I was confronted with the choice when I went castrate resistant. I was keen to initiate BAT before any further treatment but my urologist advised "at least try bicalutamide first". Point was there is a second effect of BAT. The first is just the immediate PSA response. The second is the response to rechallenge by the previously failed antiandrogen. The secondary effect is resensitisation to previous treatment. It seems to me to be a useful resistance management tool, but not so much a primary treatment. That is a conservative and risk averse view. It would be interesting to know how others here who do or have done BAT viewed it: primary treatment or management tool?

[pjoshea13]

Tommy,

For me, the idea behind BAT is to prevent or forestall adaptation to low testosterone. Which suggests that the ideal time to begin BAT is at the start of ADT. It should be most beneficial at that point & least beneficial after CRPC has occurred.

-Patrick

[jdm3 in reply to pjoshea13]

Sun Tzu's "Art of War"..... "The whole secret lies in confusing the enemy so he cannot fathom our real intent" and "to ensure that your whole host may withstand the brunt of an enemy's attack and remain unshaken - this is effected by maneuvers direct and indirect."

[Tommyj2 in reply to pjoshea13]

Unless I'm missing something ...that would be my take on it as well... but.... Every time I think I understand something SOMEONE tosses a monkey wrench into the mix that I hadn't considered : )

[j-o-h-n in reply to Tommyj2]

Technical term = MORE STUFF

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 05/03/2019 6:47 PM DST

[tetech]

This is very interesting but if you haven't had your prostatectomy or radiation do that first although the radiation does work better with androgen deprivation that's started about the same time maybe two weeks before the radiation. I read a scary article about ADT causing the mutation of the prostate cancer cells, increasing risk of deadly neuroendocrine prostate cancer.

[Tommyj2 in reply to tetech]

Thanks for the response.... my question re: first line tx pertained to first line after recurrence... I already had biochemical failure post EBRT and have been casting about for a way around standard ADT with it's many side effects and drawbacks.... This is such a many faceted disease that it's hard to know WHICH way to go....

[tetech]

I go to conferences for cdmrp. Mil and one of our patient advocates got reradiated, this time with protons. It worked (complete remission) and he has no added side effects. if you get conventional radiation they don't let you have it twice because of scarring but if you use protons on the recurrence it's likely to work if new PSA is still below about 1 (lower the better). I had a prostatectomy in 2007 and then conventional radiation in 2014 when I had a recurrence and a PSA of about 0.5 and I went ahead on did the two weeks of casodex then started lupron for a week then started the radiation. lupron for 6 months, dropped the casodex after 2 weeks (it's mainly to prevent the lupron from causing a huge testosterone surge).

I totally support the idea of Dr. Leibowitz's protocol (available free on his website) blasting with the 1200 level testosterone at the end of the ADT before your testosterone gets to those bad middling areas between 20 and 100. It used to be that he would never go back on the ADT after that. I haven't checked to see if that's changed. you can frequently test your PSA when you're on the heavy testosterone to see whether it's going down or up so you can discontinue the transdermal testosterone gel if your PSA is jumping up.

[Tommyj2 in reply to tetech]

Not familiar with Dr. Liebowitz... have a URL for his Website??

[Tommyj2 in reply to tetech]

Sorry... meant also to ask what cdmrp is??