Deciding on doing high Testosterone injections. If the PSA climbs will it be a tough job lowering it back or does this becomes difficult ?
If not then it seems more of a reason to do it.
It would be a mistake if the cancer starts to grow and would have been better off leaving the stuff alone.
Trying to not have to go back on ADT by doing the high T approach.
Do you have a particular doctor in mind to perform this therapy? I understand that there are very few medical professionals that conduct nor believe in its effectiveness.
My oncologist is ready to do this,
The theory (not yet fully confirmed) is that there is a window in testosterone level (from 150 to 450) when Prostate cancer grow well. Anything much above 450 like say, 1000 ng/dl. in fact kills cancer cells. Its akin to making some one very thirsty and then making him drink 10 gallons of water Doing this is likely to kill that person due to water overdose. This theory is called "saturation theory" by researchers. Its getting more and more known that when you sprinkle T off and on ..on prostate cancer (by doing intermittent ADT) ,cancer cells tend to remain androgen sensitive.
Its like a rice eater when continuously deprived of rice...he/she will switch to wheat bread. But if you keep giving that person rice off and on...the memory and taste of rice will remain intact and the tendency will be to stay a rice eater. This is the principle of "adaptive theory."
If you use Bipolar Androgen Therapy by loading the system by high dose of T, then make sure to do all blood biomarkers every 1 to 2 weeks...in particular PSA, PAP, and ALP.
I got my T to 1700 for 6 months and PSA rose. Stopped the T and it dropped.
Were you doing straight T not with any ADT?How are you doing now? Thanks
I was doing T +aromatase inhibitor + Dutasteride. No ADT, I've not been on ADT at all. I quit the T and Dutasteride because I wanted to get a reliable PSA reading. Now I'm back to where I was before the experiment. I asked Ed Friedman about this result and he said the T needs to get to 3000 before it kills PCa cells. But, from what I've read, some men who have T in the 1700 range experience significant reductions in PSA; others, not. No one seems to be able to explain why. According to Friedman's book it could be due to the relative number of membrane vs. intracellular ARs, but there's no way to measure that. ?? I don't think I'll try it again until I understand it better.
If you were to use transdermal testosterone [T] patches, you could get T above 1,000 ng/dL quickly and, if you needed to stop, clearance would be rapid.
With T cypionate, injected into thigh, it takes a while for T to rise to 1,000 ng/dL, let alone 2,000 ng/dL. If you wanted to stop, it could take a couple of weeks to clear.
In the context of BAT, PSA is expected to climb, but ADT brings it back down.
If you are thinking continuous T, PSA might well rise. In the instances that Dr. Myers cites in his vlog posts, the PSA settles down by the time one is out of the hypogonadal range (<350 ng/dL). If it does not, ADT must be resumed.
Regardless, you should look for an experienced doctor to work with you.
-Patrick
That's not how BAT works. You stay on ADT and have T injections at the beginning of each month. It wears off, so that by the end of each month you are castrate. No one ever comes off ADT, but it seems to extend the life of Xtandi. It does not extend survival.
Keep us posted on this trial of one!
Curious to what your thoughts are about the Decipher Test? The one which tests 22 genes and compares with 100 other men with likenesses and then “predicts” likelihood of metastasis and likelihood of various types of treatment successes such as ADT & Radiation???
It is important that PSA is not reliable for the first month or so after a supra T shot. There is usually a scary spike and should be ignored (better, just don't do the test until 2 months). One hypothesis is that the spike is due to a large number of dead cells floating around. Take a PSA just before the T as baseline, take measurements at the end of 2 months and of 3 months. Uptrend at 3 months above the baseline is a good reason to bail. Downtrend, even if above the baseline, carry on. Monitor closely. Keep open the option of going on ADT and to a form of BAT. PJ gives good reasons that the length of each phase should be longer than used in the original BAT. As a guess, 1x400mg T cypionate each week for 4 weeks, then maybe 3 months on ADT before the next round of T. A sort of blend of BAT and continuous supra T.
Do keep us informed. Experience, good or bad is invaluable.
I suggest you do a PSMA-PET before you start, again as base, then at 6 months or a year. CT and bone scan are cheaper alternatives but not as accurate or definitive (unless its small cell, non PSMA expressing cancer) Whether you use these or not, I strongly recommend a PSMA at the start. Radiological evidence is the best basis for decision making and an accurate baseline will be much appreciated 1, 2 or 3 years down the track.
You have some very good advice here about undertaking a personal SPT trial or a modified ( longer cycles) form of BAT. Kaptank’ s post should be carefully considered regarding a baseline PSMA PET and not being too quick to judge an initial PSA rise, which is expected. But a substantial and progressive rise after the first month or two would indicate you are probably not a favorable responder and should reconsider stopping it.I am doing high T cyclically: testosterone cypionate 400 mg IM will reliably raise levels to around 1000 or higher within less than a week. But at two weeks it is already dropping low. So I repeat 400 mg every two weeks.
Any treatment if kept in place for long enough will lead to the rise of resistant sub populations, as happens with chemo and ADT. The key to an adaptive approach is to mix it up or alternate treatments. I currently am trying six weeks of high T (SPT) then 4 weeks with my naturally low testosterone of ~80 (not castrate). PSA remaining just less than 0.1. Would add some form of ADT to my off cycles when it starts climbing. Only check PSA now at the end of each off cycle.
As for your original question: In the original BAT trial when those men who were not favorable responders and had a more substantial rise and progression of PSA were taken off BAT and stopped their participation, they all showed a drop again in PSA back towards or to their baseline. And scans did not identify any radiographic progression from that short term test of the protocol. There is some risk of accelerated progression nonetheless. So it is a personal decision to undertake with careful consideration. Personally, I had three consultations besides my own MO and RO before beginning it.(including Michael Schweitzer and Tomazs Beer) who thought it “reasonable and unlikely to be very harmful” when undertaken in this monitored way.
Great information. Thank You
Thank you!!!!
Hidden "-based on the patient's Gene Mapping---and Mutations"
Interesting.
I want to know more about how T therapy is ralated to gene mutations.
Anyone know where i can read more about this.
What level of PC qualifies for this therapy? Is beyond the prostate gland included?
HI Nal. I wasn't certain of the name of this test you ID'd. Is the test named "Test 328 Genes"? I did the Decipher at the same time as the GA68 PSMA CT/PET and I agree with you. Not anywhere near a roadmap for treatment, only a blueprint for anxiety if you don't already have better info. I'd be interested in your recommendation for gene tests. Thanks! Paul
T for Two............ good results....
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 11/08/2021 10:43 PM EST
Gleason score , localized pc or not. What amount of disease can a guy have that they would use this therapy on? Obviously we are all different but want the cancer dead.
What do you try to keep your testosterone level up to when you are on adt vacation?
Are there any trials going on right now applying the high T treatment?
I did BAT for 6 months last year…it worked great (for a while) but the cancer mutated past it just like all therapies in the past.
Testosterone Vs. Testosterone Replacement Therapy
Why no testosterone monitoring?
Testosterone and ADT break 
