BAT final report (until the next one).

[kaptank]

G’day space cadets. Over the last 2 years I have reported my experiences with self administered bipolar androgen therapy (BAT). You will find those reports and subsequent discussions in my profile. The short report is that ADT + bicalutamide (bical) worked for about a year before failure at which time I started BAT, which effectively extended the use of bical by about another 2 years but that was only according to PSA. Generally, response to BAT was a modest but significant lowering of PSA. However response to rechallenge by bical was quite large (greater than original) but short lived, which perhaps suggests that my pre-BAT cancer already had a population of bical resistant cells, before any had even been exposed to bicalutamide. Interesting.

Attempts to repeat the process showed much more variable PSA in both BAT and bical stages and a clear shortening of times to failure. I called a halt when PSA in the BAT phase jumped in 2 months by about 3 times (and well above my upper baseline)but on rechallenge with bical, it dropped by the same amount to end up where it started (2.5). PSA ranged from 0.2 to 4.5 throughout except for that spike to 7.5.

The last scan I have had was at the start, 3 years ago, when I started bical after zolodex alone failed. It showed 2 small lesions at the paracaval and paraaortc nodes. It wasGa68 PSMA PET CT. I have just had another but different machines and facilities. The recent machine is much more sensitive than the one 3 years ago and can pick up micro mets that were undetectable 3 years ago. There was some anxiety about the results.(understatement). Results show the 2 previous lesions but better than halved in size. Also a spot on a rib. If anything is “oligometastatic” that would appear to be a case study of it. So I will see a radiation oncologist to discuss prospects to zap them. Unfortunately here in Australia anything not black letter SOC (like zapping mets) is frowned upon.

It was a relief to learn that the disease had not rapidly progressed during the BAT period. The result was much better than I had hoped for. The radiological evidence is in.

However while I used BAT/bical over this period, I also changed significantly my use of supplements (selected from all the usual suspects well discussed here in HU) with the aim of giving PCa an environment hostile to growth and replication. While I doubt any single sup can have much effect a number in concert may.

For the moment I am just continuing with bical/zolodex and looking at what next to do. I do not rule out my using BAT at some future time. I see it as a simple tool to prevent or manage, resistance to the antiandrogens.

See youse round (like a rissole).

[Blackpatch]

Hi Kalyan’s

Your post should win a prize for the number of Australian aphorisms, if nothing else.

Whereabouts in Australia are you, because I am surprised at your comment about difficulties in getting SBRT treatment for oligometastatic PCa. I know several men being treated in this way in Melbourne, both privately and at Peter Mac. So I’m guessing you’re from one of the more, shall we say, backward, parts of the country??

Stuart

[kaptank in reply to Blackpatch]

Yup. Sydney.

[HopingForTheBest1]

Thanks so much for sharing your journey on this forum. It is very helpful. Best of luck.

[marnieg46]

Hi kaptank. I thought you might be interested in this video.

urotoday.com/video-lectures...

[kaptank in reply to marnieg46]

Thanks. Very useful. Denmeade and Schweizer have been the leading researchers and the video brings us a bit more up to date. One point to note is that although the title talks of testosterone replacement therapy (TRT) it's really about more than just replacement. TRT will generally not get to the supraphysiological levels they are actually talking about, which are more than just replacement but about 2-3 times the max physiological level. TRT has had mixed responses but BAT, which cycles between supra and castrate levels in a month, has clearer response and seems to reverse resistance.