Going Resistant - Hypothetical Question

[6357axbz]

Assume one is oligometastatic and recently hormone resistant. Will eliminating the mets mean that any new metastases that develop will start as hormone sensitive and take as long as the eliminated mets to become HR?

[Ahk1]

Very good question. I wish I knew the answer though.

[6357axbz in reply to Ahk1]

At least one guy here does...

[tango65]

If you are on ADT and your testosterone is less than 50, new metastases in radiologic studies , should be castration resistant cancerous cells since the castration sensitive cancer cells are controlled by the castration.

[Hidden]

I agree with Tango65. All the new ones will be castrate resistant, regardless of where they form. They can also mutate beyond that into other things, but they generally hang onto mutations that allow them to survive. The ones that don't aren't around for long.

There have been attempts to regain hormone sensitivity through BAT, but I don't know if there has been much success. As far as I know, it's still being studied.

[6357axbz in reply to Hidden]

Are you implying that if one go off adt after met zapping and allow t to rise to normal levels and afterwards new mets develop, they will be HS?

[Hidden in reply to 6357axbz]

Sure, if you are off ADT, then new mets can develop that are HS, I would guess that the majority would be. Hormone sensitive really means they need more hormones. Castrate resistant means that at castrate level of hormones, they still can reproduce.

[tango65 in reply to 6357axbz]

If you get off ADT after having the cancer progressing with castrate levels of testosterone, the new metastases that will appear could have castration sensitive and castration resistant cells. The problem is that castration resistant cancer is much more sensitive to testosterone than castration sensitive cancer that I believe most of the cancer cells will be castration resistant in the new metastases. This is the reason people should continue with ADT when the cancer becomes castration resistant since it has several mechanisms to respond to minimal amounts of testosterone.

[Break60]

Not sure but I hit oligomets with sbrt and have been psa undetectable and continued hormone sensitive since switching to estradiol patches.

[6357axbz in reply to Break60]

Let’s hope it continues bro.

[Tall_Allen]

No. Why would new metastases, which are more progressed than the old ones, have to be the same or different from the old ones?

[GP24]

A lot of the resistant cells are in the metastases. If you remove the mets, you remove the resistant cells. Some patients become hormone-sensitive again after removing these metastases.

europeanurology.com/article...

[LearnAll]

With each month of continuous ADT, a very small part of total cancer cell pool starts becoming castrate resistant. But, while these cells are in process of becoming castrate resistant, testosterone becomes available, they stop being castrate resistant and revert back as Androgen sensitive. This is the theory behind Intermittent ADT which has been researched a lot in Canada and s. Korea. Also in China.

But once a cancer cell becomes fully castration resistant, it loses the capacity to revert back to castration sensitiveness.

In simple way, a man who is accustomed to eating wheat bread for years..and you deprive him of wheat bread...he will start eating rice...But then, soon you provide him wheat bread, he will quickly go back to eating what he has been accustomed to. i.e Wheat bread.

But ,if he ends up eating rice for a very long time, he will not go back to Wheat bread easily.

Too simplistic..but you get the point.

[6357axbz in reply to LearnAll]

The link below is all about this mechanism and the work of Robert Gatenby.

Tall Allen probably knows the science as much, and probably more than anyone here and has reported on it often. According to him continuous still has the edge over intermittant.

wired.com/story/cancer-trea...

[LearnAll]

One size does not fit all.....it depends as PCa is heterogeneous and has different shades in different men. I will not go in any arguments over this...waste of time and energy.

I have all of published research of Zhang et al of Moffit Cancer Ctr ,Tampa in my file. Its too early to tell as I am only 8 1/2 months since I stopped ADT (started Off period) so far so good.