Friedman post : facebook.com/groups... - Advanced Prostate...
Friedman post
Here is the direct link to his publication. researchgate.net/publicatio...
It is an opinion piece of speculation about possible but not demonstrated mutations that could end responsiveness to BAT treatments. It does not address the underlying principle that the cyclic alterations of high T with castrate T exerts differential selective pressures on different Cancer sub populations (evolutionary dynamics) to stabilize and possibly prolong time to castrate resistance. Not to mention the very positive effects on the body and QOL in the meantime.
Here is his abstract. Not much more there.
Abstract: It has been shown that when the amount of intracellular androgen receptor in prostate cancer is greatly amplified, such as in the cell line LNCaP 104-R2, then testosterone will stop the growth of those cancer cells. This is the principle behind bipolar androgen therapy, which alternates amplifying intracellular androgen receptors by using very low levels of testosterone with supraphysiologic levels of testosterone. This approach has achieved some limited success in human patients. However, as these cycles continue, some mutations are expected to arise that give the cancer cells a selective growth advantage and lessen the effectiveness of bipolar androgen therapy
Paul, is your mBAT still effective? It seems like a lot of the BAT guys have been quiet. Maybe because of summer and kids, or grandkids out of school, travel, etc.? Have you heard of big failures?One of the issues I am curious of, is during the supra physiological phase, I hear is high QOL. More stamina, results at gym, better athletic performance, wives noticing their old mate is back. Then comes the ADT phase and return to castrate levels of T. It seems almost like heroin. Is it hard to stop the good feelings and return to castrate levels?
Not trying to Hijack this post, as it is related to BAT.
I want to start mBAT before I am CR. My PSA is now down to .03/.04, 6 months post SABR/SBRT. My URO/ONC says he is only SOC. I will need an alternative Med Dr., that has seen the research. We are in St Pete, FL so should be someone nearby.
Thanks, Mike
Thank you for asking, Mike. I am still on my modified BAT cycling and all indications are that it is still working very well, about 18 months in now. My situation is very similar to yours in that I am still hormone sensitive and have low burden lymph node only disease (per PSMA PET) and low PSA ranging from 0.15 when on high T then down to 0.05 at end of castrate month. Of course that is also after a round of Lu-PSMA-J591 which I received after my SBRT (described in my previous posts).
You are correct in that I feel so well on the high T phase and my body has recovered the muscle, strength, vigor energy, enthusiasm, sharpness of mind and even sexual interest and capacity on it. Indeed the real me is back. So it is somewhat hard to go onto the castrate cycles. I can feel those positive effects fading but just have a gentle acceptance knowing it is just for a few short weeks. And I have fine tuned the routine to make the transitions rapid and more complete. Can share what I have found if you ever go on a BAT program yourself. My current cycling schedule favors longer SPT and shorter castrate: 3 months on HighT: 400mg T-cypionate every two weeks x5: then switch to topical T-gel for 2 weeks while the T-cyp clears, and then none the transition week when I become castrate (hot flushes make this clear) and I start a month of Orgovyx daily. If and when this shows failure (steadily rising PSA or progression on annual scans) I would likely try longer castrate cycles of 2 or 3 months before abandoning it. I know I don’t do well on sustained ADT so that is why I have accepted the additional risk.
Getting your MO or other physician to support a decision to try cyclic BAT was a project for me, as you pointed out. I did not present it as a strategy to “help treat my PC”. Rather I made the case that I wanted to do cyclic SPT to treat my severe hypogonadism symptoms including sarcopenia, severe muscle loss, that had led to spinal disc collapses and nerve compressions. And that this did not respond to my weight training, another known effect of male hypogonadism. I explicitly declared that I was aware of and willing to accept the risks that my PC may progress faster if I undertook this, and even could die from it earlier.
I researched all of the studies on BAT, including one with HSPC from Schweizer. And on the apparent safety of SPT in early low grade PC, etc. I sent the most pertinent studies and review articles to my MO then discussed with him. At first he was adamantly opposed. Then he relented agreeing that if I could find a knowledgeable credible consultant to support this choice. I consulted with 4 (virtually) and got two that were supportive. In that, I agreed to stop if my PC progressed (continuous PSA rise or scan progression) after the trial. To this he agreed. That was my approach. You must consider the decision carefully for yourself. Paul/MB
Paul, so concise and complete. Thank you! Mike/S54
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