Last visit to University of Heidelberg was July 2020. PSA has been < 0.08.
Stopped ADT last monthly injection was 10/2020. PSMA scan July 2021
Showed some intake in LNs.
Present OC is ready to give High T injection now in hopes of stomping any remaining cancer to death . Maybe complete long term remission. OI understand that there are men on this forum that are doing High T now or have done it in the past.
My concern is to proceed at this time since PSA is <0.08 or wait till PSA rises. Last T number two months ago was four. I am sensing return of normal feelings now.
Normal T is returning therefore PSA will start to go up.
If I do the T and PSA goes up are my chances to control it with SOC still be
a workable option. Just wait and see and go straight to SOC.
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lewicki
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I am doing high T cycles with no ADT. I had severe sarcopenia. My PSA remained detectable but low and fairly stable since pelvic RT of PSMA avid LNs in late 2019. It took me three consults and lots of articles to convince my MO to allow me a trial of modified BAT. My last PSA before starting it was 0.080. Here is what we know from BAT trials which were more advanced mCRPC than me: some did very well on BAT and some did not. The latter had a prompt and strong rise in PSA with the first cycle. Those individuals were withdrawn from the study and did not appear to have radiographic progression as a result of the one cycle. I find that reassuring.
The ones that did have a favorable response to BAT over multiple cycles (2 weeks with high T, alternating with 2 weeks at castrate T). These also had a very moderate rise in PSA during the high T, but came back down to baseline or even lower when off T.
On that basis I tried 4 weeks of high T (400mg of testosterone cypionate every2 weeks X two doses). Then four weeks with the T gone. I did not do ADT in the off cycles so far, but will add that when needed. I responded very well. After three cycles, now six weeks on and four weeks off, my PSA was 0.09 at the end of the last off cycle.
I chose not to do the 2 weeks on / 2 weeks off per standard BAT because my PC was indolent and slow growing. So my guess is that slower longer cycling will be a better match to the growth cycles. Personally, my natural testosterone does not recover much off ADT, last one was 80. If it did then I would think ADT in some form should be used. (? Enzalutamide per Morgentaler? Vs Firmagon or Orgovix?)
I am very keen on doing this. My PSA is 0.008, and I am still hormone sensitive, on Zytiga Pred. I have a significant amount of pain from bone mets. Would High T cause a pain increase? ?
I don't know why I have pain of my PSA is 0.008, but I am dreaming of feeling good again, even if it is only for a few months before I go, but the fact that I'm going is not my choice with or without High T
I rank Quality of life way above Quantity of life. But we each make our own decisions. However, I can't find a Dr in Canada that will give me SPT.
One of our esteemed members here posted some videos a while ago of interviews , men on SPT, and it is not for everybody, but it has a valuable place in the treatment set. A role that is overlooked way too easily by Drs
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