Question for our BAT BROTHERS

[3putt]

Good morning all! Quick question for my brothers who have journeyed down the BAT pathway. When you made the decision to take your ADT vacation how did you go about stopping your drug intake? My MO isn’t a fan of this option as he’s a don’t fix it if it ain’t broken kinda guy so his advice regarding this path is not offered. Any info on your successes and bumps in the road would be most appreciated. Thanks in advance for your consideration.

[3putt]

tanks for the clarification

[MateoBeach]

Can be challenging to get an MO on board with BAT, and modified BAT.

One avenue: Show research that IADT, intermittent ADT is "non-inferior" to continuous ADT and improves QOL. However, if testosterone does not recover to normal (eugonadal) within a few months, then it is not really IADT and supplemental testosterone replacement is appropriate. And high testosterone levels (not just normal or sub-normal) has been shown to suppress PC growth. That is the basis for BAT.

Another avenue (the one I took): That I developed severe and harmful hypogonadism symptoms, physically, emotionally and mentally, including severe sarcopenia, on ADT and my testosterone never recovered when it was stopped. High dose replacement testosterone is the only way to correct it. And I was willing to accept the associated risks. And I chose to alternate high T with shorter castrate ADT cycles (modified BAT), and carefully follow PSAs and periodic scans. Would stop if progression develops.

Very personal individual choice. Not recommending it for you. Just explaining presentation possibilities for discussion with your MO. Paul

[3putt in reply to MateoBeach]

thanks

[cesces]

Without necessarily firing your current doc, you really need to get a consult with one of the few docs with experience doing BAT.

[3putt in reply to cesces]

that’s the plan. Good advice

[Ramp7]

MY Dana Farber MO is good friends with the group at John Hopkins. This consideration may be on deck for me. Great information here.

[3putt]

Insightful article. Most appreciated.