Testosterone Cycling (BAT) provides enhancement of body composition and QOL

[MateoBeach]

Introducing testosterone replacement or therapy for advanced PC patients is a tricky and risky undertaking. This has been much discussed in this forum. Perhaps it has a place for some specific men with mCRPC who become unresponsive to other treatments and are willing to risk accelerating their cancer. Perhaps the most likely scenario are those on intermittent ADT regimens who do not spontaneously recover normal testosterone function in a timely manner, and are functionally not really getting an ADT "vacation". Others (myself included) have severe hypogonadal symptoms and sarcopenia from ADT and are willing to risk accelerating indolent PC in order to benefit from some form of cyclic testosterone. This must be a carefully considered personal decision that is not SOC. Further research is ongoing to clarify for whom BAT or cyclic TRT might be reasonable or appropriate.

The following article shows surprisingly profound effects of BAT to improve body composition and Quality-of-Life. Perhaps not so surprising after all.

bjui-journals.onlinelibrary...

Reversing the effects of androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer

Catherine H. Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, …

First published: 25 March 2021 doi.org/10.1111/bju.15408

Abstract

To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.

Patients and Methods

Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy – Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.

Results

The 60 included patients lost a mean (sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman’s correlation coefficient 0.58, 95% confidence interval 0.35–0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life.

Conclusions

In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.

[MateoBeach]

Photo is last week in Idaho Sawtooths on a pass above Twin Lakes. Multi-day backpacking facilitated by 3 months training while receiving testosterone replacement cycles. One month on, one month off. No ADT currently. PSA 0.10 from a nadir of 0.08. Wife and Mateo loved it too.

[podsart in reply to MateoBeach]

Fabulous view! What level did your testosterone reach?

You say “no ADT currently.” Does that mean you are only getting testosterone shots with no Lupron, Zytiga, or Xtandi?

[MateoBeach in reply to podsart]

Correct. I don’t check my peak T levels as I know it is high on that dose. But checking how low it drops at end of the off cycle along with PSA. No ADT currently as the consultant advised just seeing how it behaves without it for the initial cycles. So far so good. But I am ready to add Firmagon ADT at any sign of PSA progression. It’s uncharted territory and there be dragons. 🐉

[podsart in reply to MateoBeach]

Thanks

Good luck ; consider asking what the dr thinks about adding xtandi rather than firmagon

[MateoBeach in reply to podsart]

Yes, that is what Morgental is doing in his small group on “modified BAT”. Curious about that.

[podsart in reply to MateoBeach]

Might be useful to explore

[treedown]

What a beautiful picture. Glad BAT is working for you if it gets you to places like that. We hiked up to a nearby glacier a couple weeks ago and it was beautiful. It helps keep things in perspective .

[Gearhead]

I appreciate your effort to be balanced and objective in your comments introducing this subject and article.

[j-o-h-n]

Hopefully you picked up after your dog......... the Mounties may have be watching........

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/20/2021 7:57 PM DST

[jeffersonsam99]

This is first time, I heart about the testosterone replacement for PC patient. Thanks for your information for PC patients. Many men are facing poor erection experience after suffering from PC disease. So overcome poor erection problem also important thing.

[Spyder54]

Paul,Love that view. The pic is a keeper. Your physical look is much better than mine. I am 67 yrs, up 25lbs in 11 months with weights and active excercise (pickleball, yoga, mobility excercise, hiking/dog walking, cycling, Stand up paddling, kitesurfing in that order).BAT & mBAT have been big topics lately. I have one of the Gene DNA Repair issues also, according to TA, making me a good candidate for BAT. Am I right to assume I should wait until castrate resistant? Or begin (with strict Dr supervision) while still castrate sensitive? I long for a return of muscle mass, weight loss, libido, old personality traits as most studies hv shown!!

Thanks,

Mike

[Spyder54 in reply to Spyder54]

Michigan

Hartwick Pines forest hike, Grayling, Michigan. August 2021