My Intermittent Bicalutamide mono therapy

[traveller64]

Following PSA recurrence in late 2014 I've been treated by bicalutamide 50 mg. In Sept 2020 we decided to give a break and stopped all medication (bicalutamide and tamoxifen). At that time my PSA was 0.02 and testosterone only 58. Note that tamoxifen is causing my T level to go down. Anyway, I am free of medication for the last 6 months and PSA is still very low at 0.19. T level is slowly recovering, now it is 214. MO thinks we'll consider to go back to casodex when PSA reaches 0.6 - 0.7. I'm just sharing my experience, not recommending any treatment approach.

[Hidden]

Great News...I had the same good news for for 6 years on Cassodex.

Then PSA started climbing and I am on the ADT - Doxetaxel train.

Ride the Cassodex as long as you can....

[Tall_Allen]

Congratulations! Intermittent hormone therapy makes sense for recurrent non-metastatic men.

[Ran2599dy]

I have had PC for 17 years and the last four years I have been able to control my PC by using Casodex 50mg one per week . Casodex has a half life of seven days and this seems to be enough in my case. My PSA has stayed steady at .23 and my T is 124.

[traveller64 in reply to Ran2599dy]

I tried Casodex 50 mg one tab per week but it didn't work out, Psa started to climb. I switched to two tabs a week and it kept PSA stable for two years. Then I switched to one tab a day.

[LearnAll]

Hi...A big Hi.. Fellow traveller ..I call you fellow traveller sitting on next seat to me..because I am also on Bicalutamide Monotherapy (50 mg/day)myself for last 8 months. Almost no side effects. I am also doing monotherapy intermittently. Latest PSA 0.4 and Bone ALP 14 mcgm/L. MRI of spine done 5 days ago showed no active bone mets on spine. Your MO is great man..He is not a SOC peddler.I agree with your plan to go back to Casodex (bicalutamide) if PSA starts rising. But next time, eat a lot of sulforaphane rich food with it. These foods are Cauliflower, Brocolli, Radishes, Cabbage. Mustard greens. They make Casodex work for long time.

[traveller64 in reply to LearnAll]

Hi LearnAll, major side effect of Casodex for me is loss of body hair and decreased libido. When PSA hits 0.5 I plan to have a PSMA PET/CT. Thanks for the diet recommendation

[LearnAll in reply to traveller64]

Loss of body hair and loss of libido are common side effects of lupron. Can't say about body hair but after Casodex monotherapy libido returned and even performance recovered albeit not fully. T went from 1.5 to 455 after being on Casodex only. I am truly pleased with Casodex as side effects are not even noticeable to me. Its possible that my plant-based, herbs rich diet and supplements might be helping me.

[LearnAll]

SOC agents and SOC oncologists never talk about how to keep current treatment working longer. Do they ever tell that Intermittent use of anti androgens keep them effective longer?Do they evr tell that suforphane rich and/or organic sulfur compounds can keep anti androgens work longer?

Do they ever tell that adding Niclosamide, an anti worm medicine or Carbidopa can bring back the effect of bicalutamide ? . Lots of things go unreported.

[BILIE in reply to LearnAll]

Could you please expand on:

"adding Niclosamide, an anti worm medicine or Carbidopa can bring back the effect of bicalutamide" ....

[LearnAll in reply to BILIE]

ncbi.nlm.nih.gov/pmc/articl...

This is one of the study which tell that Bicalutamide resistance can be overcome by using Niclosamide along with it.

Same type of study is availble about use of Carbidopa.

[BILIE in reply to LearnAll]

THANKYOU VERY MUCH !

[traveller64]

Nalakarts, I was very impressed when I read Dr Gatenby's article on Adaptive Therapy. My MO in the US was not in favor of intermittent bicalutamide therapy and he said intermittent therapy is effective in ADT (Lupron). He expected PSA to increase in a couple of months, but did not object to give it a try. Recently I shared PSA results with him, he was happy with the results and recommended to continue the drug holiday until PSA hits 0.6 - 0.7.5 years ago I had tried intermittent therapy but it lasted for 4-5 months. Now it seems that the drug holiday will be longer, may be close to a year. It's very good but I'm curious why it's taking longer after 6 years of bicalutamide therapy.

[LearnAll in reply to traveller64]

In the beginning, All cancer cells are VERY sensitive to androgens but after being on ADT ,gradually ...with time...some cells start becoming less sensitive to ADT....more time passes...more cells become less sensitive to ADT....and eventually ..some of the cells become fully resistant to ADT (called castration resistance) And out of those castration resistant men, approx.30% end up developing treatment emergent Neuro endocrine variant.This phenomenon happens in every man with Prostate Cancer BUT the conversion rate from Androgen sensitivity to Androgen Resistance proceeds at different speed in different men. In some ,it takes only 2 years and in others it happens after 5, 10 or even 15 years. It is being realized more and more that ADT vacations RE-SENSITIZE the cancer cells to ADT and in this manner prolongs the time TO castration resistance.

Fear of flare up of cancer stops Oncologists and patients from trying Intermittent treatment. In fact, not every one is suitable to try Intermittent treatment...Risk level varies from one man to another. However, a good, detail oriented Doctor can figure out risk level in his /her patient and is able to make a judgement whether one is suitable candidate for Intermittent or not.

[j-o-h-n]

Intermittent the best word to describe my sex life with my ex-wife...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 04/01/2021 7:22 PM EST

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

Intermittent means you actually got started.... Good result....