Cyclic high dose testosterone + Nubeqa

[AllenMarco]

I've been on Nubeqa as a sole agent for last 30 months and PSA has raised to 4.0 after staying under 2.0 for the first 2 years. I've lost a lot of strength and muscle mass from the Nubeqa and after reading about cyclic testosterone treatment I discussed it with my MO. His attitude was "ok, let's try it" keeping me on the Nubeqa. He said if this fails my next step is docetaxel and lupron. All of this has me really nervous and I hope I'm getting the best advice from my MO. Thoughts?

[mrscruffy]

I beat muscle loss with 5 days in the gym lifting heavy and using Ostarine. As of today the Ostarine has stopped my PSA from rising

[Hidden in reply to mrscruffy]

Ostarine and Rad-140 are great additions for ADT. My test results show no interference with doses all the way up to 35 mg/day. My MO told me to keep doing them.

[George71 in reply to mrscruffy]

mrscruffy, what is it about Ostarine that makes the PSA stop rising in your opinion?

[mrscruffy in reply to George71]

It suppresses Testosterone production

[Tall_Allen]

That is similar, but in important ways very different, to what they did on the RESTORE BAT trial, except with Lupron+Xtandi rather than Nubeqa alone, and they tried it after Xtandi had failed (which is your case). You can read about it here:

prostatecancer.news/2016/09...

As you see, it did restore sensitivity to Xtandi in a majority of men. But the way BAT works is without an anti-androgen (Nubeqa is an anti-androgen) taken at the same time. The reason for this is that you want the testosterone to over-stimulate the androgen receptor, thereby causing it to regress. By staying on Nubeqa, you are blocking the testosterone from the androgen receptor. In fact, your serum testosterone levels may be high already because your testosterone has nowhere to go (I would guess you are getting gynecomastia). Also, BAT requires alternation of high-testosterone and low-testosterone states. You probably already are in a high testosterone state and will only make it uselessly higher (useless, because the testosterone cannot get to your blocked androgen receptors.

Also, I think it is important to monitor progression with PSMA PET scans and not just PSA tests.

[GeorgeGlass in reply to Tall_Allen]

What do you think about Marco doing Nubeqa without ADT? Would it be best to do it that way, 1) Nubeqa w/no ADT, 2) Nubeqa with ADT, or 3) a hybrid, such as doing intermittent Nubeqa and/or ADT to keep the cancer off balance?

[Tall_Allen in reply to GeorgeGlass]

I just explained why anti-androgens cannot be used with BAT.

[GeorgeGlass in reply to Tall_Allen]

I'm asking about which of the three options I listed without BiPolarAndrigen (BAT) therapy. Basically, mono-nubeqa vs. nubeqa with continuous ADT vs. Intermittant ADT and intermittant nubeqa?

I presume no studies have been done to compare these options.

[Tall_Allen in reply to GeorgeGlass]

Gotcha. No - no studies of Nubeqa monotherapy that I'm aware of have reported results. This trial in Europe should have results next year:

clinicaltrials.gov/ct2/show...

[GeorgeGlass in reply to Tall_Allen]

thanks, I'll look forward to seeing those results.

[Hidden]

We don't have any data for the BAT/Nubeqa combo. But if you wanted to do that I would think that the only way it might make sense is to use Nubega only on the low T phase of BAT and stop the Nubeqa a week before the high T phase so that it can wash out.

I don't think that high T and Nubeqa is going to be a good combo. Your total T would be high but so what? Your androgen receptors are blocked.

Possibly a modified BAT program or perhaps just cycle some SARMs into your current treatment.

[nuc1111]

Dear Nalakrats--I have BRAC2---did I understand you to say I might do better with BAT? I am on Zytiga and Orgovyx. Bladder and lymph nodes positive--- I would look forward to the positive jolt testosterone would give since I am onADT.

Thanks for all you do for us on this web site-

Ed

[mrscruffy]

Ostarine can adversely affect HDL so I started with 10mg for 4 weeks then 4 weeks off cycle. When I did my first HDL check my HDL jumped from 41 to 53 which is great. I then upped my dose to 20mg for 6 weeks. I get HDL results tomorrow. Only negative thing is at 20mg I started to suffer fatigue in last 2 weeks of cycle. In two weeks, I cycle on again and will drop dose to 15mg to help with fatigue. My doctor knew all about SARMS and said if I was his son he would have me take them he just couldn't officially tell me to because there is no FDA approval and is a bit controversial. Legal to buy, legal to posses and not recommended for human consumption

[GeorgeGlass in reply to mrscruffy]

What caused your HDL to rise that much?Why do you take Ostarine?

What do SARMS do?

[mrscruffy in reply to GeorgeGlass]

Not sure why HDL went up it should have gone down. Decrease in HDL is a SE of Ostarine. I take Ostarine to build muscle and strength while warding off muscle loss caused by ADT. A benefit of Ostarine is it also decreases T production which helps keep PSA low. `Briefly, Ostarine blocks T production while telling everything else in your body to build muscle and strength quickly. Combined with proper nutrition and plenty of gym time lifting heavy the body piles on muscle. My arms are noticeably larger my legs are insanely strong and my shoulders are getting big while PSA is stable. Mission accomplished

[GeorgeGlass in reply to mrscruffy]

Did the Ostarine cause you any bad side effects?

[mrscruffy in reply to GeorgeGlass]

At 20mg started to feel fatigue, cut back to 15mg and went away. Since it is not an FDA approved compound experimentation is in order. Legal to buy, Legal to posses but "not for human consumption"

[GeorgeGlass in reply to mrscruffy]

My T is already near zero so i suppose that the sole purpose for me, of sarms, is to avoid saropenia related problems?

[mrscruffy in reply to GeorgeGlass]

Exactly, and ADT increase loss in bone strength

[mrscruffy]

Curious as to which SARM he recommended, I was thinking about stacking another one

[nuc1111]

Thanks Nal

[Hidden]

Which one? Ligandrol (LGD-4033), or perhaps a pseudo-SARM like Cardarine or YK-11. I've used all of those and S3, S4, and one or two others.

[GeorgeGlass]

4 months ago... what did you and your doctor decide to do, and how is it going?

[mrscruffy in reply to GeorgeGlass]

PSA is stable so continuing on same plan