Had a meeting yesterday with my MO and asked him about The TRANSFORMER Study, BAT and Adaptive Theory. He is very committed to SOC and I was surprised that after our discussion he said I should contact Dr Russell Szmulewitz at The U of Chicago who was one of the authors of the Transformer study.
My MO seems open to the idea of BAT which I am appreciative of.
Has anyone dealt with Dr. Szmulewitz?
Most Docs, especially those at large institutions, just aren't going to vary from standard of care.
If you want BAT you really need to find one that was involved with the original trials.
Great that he opened the door to that. Take the referral to consult with Szmulewitz. Your MO is looking for support and cover to authorize and manage it. Same thing I went through, consulting with Schweizer and also Beer. Approved my modified BAT that is working so very well for me now, 8 months in.
Who is Beer?
Tomasz Beer, longtime very well respected PC clinician and researcher in urologic oncology at Oregon Health Sciences University in Portland. Did a virtual video consult with him about my whole case and cyclic testosterone.
I earlier saw some cautionary comment about Beer..did you find him brusque, etc? Have you had any other interactions with OHSU PCa team?
Dr. Beer was very gracious and friendly. Very thorough review of my entire history and symptoms and not just addressing the single question about BAT for me until he had the whole picture. I enjoyed the interaction and he was very generous with his time. Then he wrote an excellent summary letter for me and my MO, stating at the end that I “would be very unlikely to be harmed by the cyclic testosterone that is proposed with appropriate monitoring.”In 2019 I went to OHSU to have my PMSA scan (from UCLA) reviewed by Dr. Arthur Hung in Radiation Oncology. He supported the proposed treatment plan of my local RO for treatment of pelvic LN fields with IMRT. Pleased with all contact at OHSU.
Mateo Who manages your BAT therapy now?
My local MO officially. He writes the T-cypionate prescriptions and approves my timing and lab monitoring. But he accepts my carefully considered plan on my terms. I can buy testosterone over the counter when I am here in Mexico so frequently. But I wanted to have him on board and in the loop. I will need him when this inevitably stops working. So far it is really excellent. Feel so good, so much stronger and energetic, and PSA is still low and stable.
I thought that name looked familiar. He worked on the trial for taking low dose (250mg) Abiraterone with a meal.
We were referred to Dr Szmulewitz shortly after diagnosis, for a second opinion on initial treatment. We met virtually. We liked him very much. He was thorough and informative. I highly recommend you pursue his input!
My husband is not a patient of Dr Smulewitz but I emailed him about the low dose Abi study and he very nicely responded. I was quite impressed
My local MO gets uncomfortable with it when I bring it up too, however my PCa specialist is Dr. Sartor who is also one of the authors of the Transformer trial. When I saw him in November we put BAT on the shortlist of therapies going forward now that I’m castrate resistant. PSA is still too low to start anything like this. Sartor has a lot of experience with BAT, he said it’s not for everyone but felt I was a good candidate.
Ed
What makes a person a good candidate?
Age, physical status, current cancer status. I’m just coming out of cancer dormancy after 6 years of being undetectable. My PSA is still very low. As Sartor put it “he wouldn’t advocate BAT for a 90 year old man in a nursing home”
Ed
I’d only see the Transformer study for CR men but your post resulted in me searching and thus found the BATman study in HS men. Thanks!
Nal
I do intend to get involved, I am actually thinking sooner rather than later, if I can find someone to prescribe it for me. So far I am responding very well to the ADT +Abi + Pred my PSA is at 0.25 after 3 months. I am thinking that once it becomes undetectable I would like to try BAT ASAP. Goal is To keep PCa from becoming hormone resistant for as long as possible and to avoid the devastation to my body from the ADT.
Dr. Szmulewitz is my MO, and he treats at least one other poster on this site. I love the guy. He says he is a SOC guy, but can be convinced to think outside the box. He is, however, generally opposed to T supplementation, so i don’t know if he will be receptive to BAT for someone who is not yet castrate resistant. The transformer study dealt with castrate resistant patients, and I think everyone agrees they are more difficult to treat.
Thanks George
I thought I had heard of him before, now I remember that you suggested contacting him.
Maybe the BATman trials will sway him.
Hope you are feeling well, have a safe and healthy New Year
Hello canoehead , Scout told me you have Dr. SZmulewitz . I will see him 1st time on Jan. 7 , My RO Dr. Hirsch referred me to him . I had primary SBRT in 2016 and recently PSMA-PET , pylarify at VA , and it showed 1 hot lymph node in pelvic area . So far RO wants to do SBRT , 3 sessions to LN and 25 sessions IMRT . . What are your thoughts of DR. SZmulewitz ? Thanks John
I put my basic thoughts in an earlier post in this thread. Additionally, he will take the time to answer questions. If you bring up a recent study to him, he will either know about it already or he will make himself knowledgeable. He appreciates patients who understand the finer details about their treatment and condition. This should tell you everything you need to know: a few years ago (pre Covid) I had a 7:20 AM appointment with him on a winter morning, and he was obviously sick with a bad cold or the flu. I asked him what he was doing at work if he was not feeling well, and his answer was, “cancer doesn’t take any days off.”
Hello Again Scout , I will be seeing Dr. Szmulewits Jan.7 , referred by my RO. I will be starting radiation soonthere after . What can you tell me about DR. Szmulewitz ?
Might want to contact Canoehead on this board, he is a patient of Dr. S. and is very pleased with him.I have not yet contacted him as I am not yet ready to start BAT. I want to get off Lupron as soon as possible, 1 year or 18 months at most.
Could BAT be our last chance?
Anyone Familiar With a Research Study JH17U01?
BAT question. A little worried about results. 
Would I be on thin ice if I tried adaptive ADT this soon?
