not sure my Onco (or I)understood the Denmeade BAT paper.

[Frigataflyer]

Help. Not sure that my Onco understands BAT.

This is a short summary of my treatments Jan 2019 to present. 

Dec 2018  PSA 176 Gleason 9.  

Casodex only one month (PSA 33)

Lupron (PSA Nadir 0.76)

Lupron + Zytiga, 

Orchiectomy + Zytiga  (PSA Nadir with Zytiga = 2.74)

 Zytiga failed but continued with Zytiga because of lengthy delay in obtaining Xtandi.   By the time I got the XTandi from India my PSA was 67.  Onco decided to delay Xtandi and go to Docetaxel to bring down PSA

I had 6 Docetaxel treatments.  The last two were accompanied by Carboplatin and 40mg and 80mg of Xtandi respectively.  This lowered PSA to 6.  

That was three months ago.  Last week, after 3months of 160mg/day Xtandi  my PSA was 72.

Three months ago I gave my Onco the Denmeade review paper on BAT and yesterday he directed me as follows:  Stop Xtandi and take 250mg of testosterone per week for 6 weeks after which plan is to restart Xtandi or ???

Inremember (I think) that in BAT the testosterone is given once per month and allowed to taper down before the next injection.  And I think I remember that one continues with whatever ADT one is using during the testosterone cycling.  

Is my Onco’s treatment plan BAT or some new testosterone treatment?  

I live in Mazatlan Mexico and my Onco is a young MD who is not a prostate specialists but he follows the international SOC for prostate cancer. BAT seems to be unheard of here.

any help would be much appreciated.

I feel great and have no bone pain at all. On Monday I am getting a CT scan of neck and abdomen.

[cesces]

you really want the bat supervised by someone with experience using it

Maybe do your first cycle with weekly psa tests while you get yourself to someone with experience.

Sartor at Tulane is not far from you. He can supervise while your local doc implements.

Sartor isnt all that expensive if all he is doing is long distance supervision.

Bat has lots of nuance that hasn't yet shown up in publshed papers.

[Tall_Allen]

You are right that in the RESTORE trial they cycled between testosterone and castration monthly. They continued cycling for 3 months and then checked metastases with a bone scan/CT. If no sign of progression, they continued cycling. If there were new or larger metastases, they re-challenged with Xtandi.

ncbi.nlm.nih.gov/pmc/articl...

However, BAT has never been shown to increase survival. You would be better off with Pluvicto.