Is ADT beneficial after castration resistance sets in?

[GeorgeGlass]

If PSA is rising at the same doubling time (3 weeks) as it was without ADT (when I was Castration sensitive and did intermittent ADT breaks), then is it useful to keep taking ADT? If so, why? Is that because the ADT would be slowing some castration sensitive cancer, even though the castration resistant cancer is growing separately?

[cesces]

" Is that because the ADT would be slowing some castration sensitive cancer, even though the castration resistant cancer is growing separately?"

Interesting point. Maybe the doubling rate would be even faster without the ADT.

But no matter. It's time to change up and try something new.

It seems to me, unless you have some unique reasons to the contrary, it's really time to try a few months of BAT therapy next.

Just to see if that works for you.

If not, its time for some heavy chemo and/or lu177

[GeorgeGlass in reply to cesces]

Good thoughts. I'm working on trying to get provenge, then maybe trying BAT or Nubeqa and a different statin, like simvastatin or Livalo.

[Teacherdude72 in reply to GeorgeGlass]

After psa doubled twice in two months on Eligard switched to Lupron monthly.

After one month with psa dropping to 1.0 started Nubeqa. After two months of that, Lupron monthly/nubeqa, my psa has stayed at <0.02 for 15 months.

[Tall_Allen]

one of the reasons for castration resistance is that the androgen receptor becomes very sensitive to even the smallest amount of testosterone. So it is more important than ever to take androgen deprivation.

[GeorgeGlass in reply to Tall_Allen]

never miss my one a day orgovyx!

[RCOG2000 in reply to Tall_Allen]

please share link to the trial evidence for this

[Tall_Allen in reply to RCOG2000]

We learn the mechanisms of castration resistance from lab analysis, not trials. It's called AR amplification. It would be unethical to withhold ADT.

[joeguy]

You and I are on a very similar trajectory. I am also doubling every 3 weeks while failing orgovyx and Darolutimide. Currently hopping to get LU177 through SPLASH trial.