Advanced late stage PCa with neuroendcrine differentiation: crazy to consider SARMs?

[FuriousGeorge]

My dad had Stage 3 Recurrent PCa. As of August, it was well controlled with hormone therapy, based on imaging and hormone levels. Unbeknownst to us, it had probably already begun to change.. Before even becoming CRPC, it mutated into Small Cell Carcinoma of the Prostate and metastasized.

I won't go through his history for the sake of brevity, but I did here, in case anyone's interested:

healthunlocked.com/advanced...

The short version is:

We discovered the metastasis when a mass blocked his kidney, causing back pain. He thought it was a strain, after two weeks of suffering he ended up in the ER with low oxygen levels. He may or may not have had pneumonia, but long story short: in the course of two weeks laid up with back pain and two weeks in the hospital, and he went from being an otherwise very healthy 72 yo man with controlled PCa, to being almost completely debilitated. He can't get out of bed, everything hurts to the extent that even changing positions is excruciating, and he needs to be fed, and changed, and everything else.

Obviously, he is too sick for chemo. Our only hope (and we need hope) is that he becomes stronger

To that end, I have some amateur "body builder" acquaintances that use SARMs. These are being studied for PCa because they are androgen antagonist in most tissue, but they are agonist in skeletal muscle tissue.

He has lost so much muscle between the month laid up, the cancer, and the hormone therapy that I fear that even if everything breaks right, he won't have enough time to get stronger.

The folks who use it report that their testicles do not shrink while on it, so I know it is at least not androgenic there. Other than that, it is obvioulsy hard to prove they have what they think they have (though I know they get it from what is considered a reputable vendor).

Is this a worse idea than it is seeming to me at this point?

EDIT: The biggest problem I'm seeing is the SARM that made it into phase iii research for cachexia did not perform well.

[noahware]

Would your father's docs be in the loop on this?

In practical terms, the question isn't really what we might think of SARM use, but what the docs might think, assuming your father is going to stay under their care. Because even if you hear some resoundingly positive views of SARM potential on this forum (which I frankly think is unlikely) that is going to need to translate into an actionable protocol: which SARM, at what dose, for how long, under observation of which docs, etc.

Just "winging it" should not be an option.

Unless you are in a clinical trial, anything that falls outside the mainstream "standard of care" is rejected by most docs (if only on liability grounds) and for many men that means "going off the reservation" and designing their own protocols while under the care of that rare doc who is willing to accept patients doing this.

Personally, if I were to pursue something outside the mainstream norm of care, I would consider supraphysiological T before I considered a SARM. The approach of high-T is at least something that has been studied and used for decades, with some understanding of potentially beneficial mechanisms of action, but a major problem still being there is not a good way to know which men will respond favorably and which unfavorably. So while that is a risk I would accept for myself, I would not want to be in a position make that decision for another.

[FuriousGeorge in reply to noahware]

Thanks for the thought out reply.

I can get Ostarine, which was in the PCa cachexia study.

I asked the doctor about it. I'm not sure she's heard of it. Naturally, she said she did not think it would help. Naturally, I can't blame her.

She also said, based on his liver, he has days to live, and will not become well enough for chemo, "but sometimes patients surprise us" is all I heard.