Happy to share my latest progress report. Note that I am mHSPC, lymph nodes only to pelvis and abdomen. I have been on long-cycle modified BAT for 2.5 years now. 3 months of very high testosterone (400mg T-cypionate every 2 weeks), then one month of ADT using Orgovyx. My PSA has continued to decline on this regimen. It was down by 90% in January 2023 to 0.030. Now it has become undetectable <0.015. These were measured at towards the end of the ADT month of each cycle. So my next step will be to measure it during the high testosterone phases.
This provides a convincing example that, contrary to the "conventional thinking" that BAT is only appropriate for metastatic castrate resistant (mCRPC). That indeed it can be effective in controlling Hormone Sensitive PC. Perhaps even more so? I hope there will be a clinical trial for it soon. (Dr. Michael Schweizer? Denmeade? Anyone?)
However, my treatment also included an aggressive radiation treatment, which no doubt also contribute to the excellent response so far. That was SBRT to my oligometastatic nodes followed by molecular targeting radioligand treatments using the experimental monoclonal antibody ligand for Lu177: Lu-PSMA-J591 from GenesisCare in Perth Australia. Two infusions given one month after the SBRT.
Sending profound gratitude to all of my physicians and care teams for supporting me in my non SOC approaches. And to all of you, my friends and supporters on these forums. MateoBeach / Paul
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No, that would not be BAT. Periods of very high testosterone must alternate with periods of ADT. So Orgovyx only the one month out of four for my "off" period. Note my regimen is not the standard BAT protocol. ADT is overwhelmed by the high T levels during the "on" cycle. So it would just be wasted.
Paul is taking orgovyx. Orgovyx typically reduces your body's T to zero within 3-5 days. Unlike Lupron which Denmeade is using. Lupron has a "flare" that lasts about 10 days. And then T slowly drops so you don't get to castrate levels for almost a month.
Either one will work.
If you use Lupron or another GnRH agonist you have to stay on it full time.
The point is to remove your own body's T out of the mix. Only at that time can you completely control it exogenously (T shots, gel, orals).
Denmeade also doesn't recommend for HSPC for whatever reason. I think he is compromising with the drug industry. Think of the money lost if HSPC and no AI drugs for his 30 day high T cycle. Unfortunately one needs to be a diplomat and compromise or he could be ridiculed by his peers (no joke, it does happen).
His other constraints are reliable predictable data in the clinical trials so he goes with 30 day cycles not PSA or scan data to determine to continue High T or ADT phase.
Yes, Scout. I co-manage my BAT regimen with the support and blessings of my MO. He prescribes both the testosterone cypionate and the Orgovyx. These are covered by Part D Medicare, though the co-pay for Orgovyx is extremely high. Fortunately I only need 3 months supply for a year.
Hi Paul, can I ask how you approached your conversation with your MO to persuade him to support your decision? I have this conversation coming up in a week.
I DO NOT want to lose my MO or this excellent hospital MGH. I will be providing my own t-propionate but will want to ask him for an aromatase inhibitor (letrozole) while on High T at 3000ng/dl. I will also be using quest for my frequent testing and hospital for my usual quarterly testing. I am on Daro and Orgo and SARMS.
Very impressive. I too am doing a self administered BAT protocol. For Testosterone I am using Propionate. May the dance continue. Turn up the music Coco.
Just curious if you are paying for this out of pocket or if insurance is paying for the any part of it? Its a great result and if it leads to something down the line in the way of treatment for all that also would be a great result. However, out of pocket would be out of reach for most I suspect.
Happy for you and your wonderful results. Undetectable has been my favorite word for the past 10+ years so Bravo to you. Just curious if your response and results can be attributed to the SBRT to your oligometastatic nodes followed by molecular targeting radioligand treatments using the experimental monoclonal antibody ligand for Lu177: Lu-PSMA-J591 from GenesisCare in Perth Australia versus the BAT protocol. Best to you to remain “undetectable “
Im in Sydney Australia. I notice references to Perth West Aus. Are you doing BAT in Perth or USA as I would love to 'experiment' with BAT but cannot find a Physician in Australia who is willing to help me. Any advice is welcome.
you have to do some research and reflection to decide whether some form of BAT might be beneficial for you. It is not a big stretch as if you do not respond favorably you can just stop it with minimal to no harm.
You might need to provide a condition that medialcally justifies Testosterone therapy irrespective of PC. This would be severe hypogonadism with physical and mental symptoms including sarcopenia and depression for example. Perhaps a non oncology doctor or naturopath would then be willing to prescribe it. Especially if you provide peer reviewed articles about BAT. Then just watch your PSA response to know that it is working favorably.
MateoBeach wrote -- " ... However, my treatment also included an aggressive radiation treatment, which no doubt also contribute to the excellent response so far. That was SBRT to my oligometastatic nodes followed by molecular targeting radioligand treatments using the experimental monoclonal antibody ligand for Lu177: Lu-PSMA-J591 from GenesisCare in Perth Australia. Two infusions given one month after the SBRT ... "
After reading postings and other information *r.e. - BAT* I'm thinking that many/most trying BAT might have thrown lots of treatments including the *kitchen sink* into/at their body so ultimately it could be some shade of gray as to success being due only to BAT or success due to the cumulative effect of all.
My *BAT Game* is not truly BAT since mets. have yet to make an appearance from the GL10 tumor (maybe working) and unlike others I have half a prostate as a sacrificial zinc, my ADT is via castration NOT Drugs, my treatment was by cryoablation + IRE and an Immuno injection to build up immune system -- NO RP, NO Chemo, NO Radiation, NO monoclonal antibody ligand treatments AND I only cycle *T* between 1,600ng/dL and <2.5ng/dL.
Playing with the numbers and always playing the tune in my mind >>>
Great results. Congrats and thanks for proving information on your protocol. I think it would be difficult to replicate in U.K. where SOC generally rules
I agree this would be so difficult here in the Uk with SOC straight jacket and Orgovyx not being NICE approved.
However I have reached out to DR Nat Lenzo to arrange a zoom consult re J591 before I make any decision re changing my protocol of Zolodex and Apalutamide. A holiday in Australia with a couple of infusions would be doable if there was any value whilst undetectable and NED on scans but knowing the micro mets are probably lurking!
Congratulations!
I have been on BAT for three months, last six weeks PSA is flat, 3.4. Will be exciting to see the results in the next months. PSMA and FDG scans are negative.
Text; "This provides a convincing example that, contrary to the "conventional thinking" that BAT is only appropriate for metastatic castrate resistant (mCRPC)."
What? Why on earth would SOC think that adding TET is 'safe' only for resistant cases? Think about this...soooooo the SOC states that TET vis a vis BAT treatment is potentially dangerous and its 'pouring gasoline on the fire,' soooooo we will only give it to men in whom ADT does not work to stop TET based PSA rise from advancing? Am I making the point here? If TET is so dangerous for men and any amount is correlated to progression/ ignition of PCa, why approve BAT treatment only for men for whom ADT does not work?
Ah, forget it...was using logic and that does not work in all cases. But your post is of interest. You do point out though that the excellent response you are having could be from any number of treatments you have received, combinations, or interactions...but if it works continue down that road.
I have posted extensive on TTr (testosterone replacement) and whether it has ever been necessary to take men's TET to ZERO for effective treatment. It appears that it may not be required (see below). Your testimony gives proof to that cause. Rick
Can you explain the theory of operation here for CSPC? My understanding for CRPC is the following:
With the use of ADT/etc: the PC cells (can) respond to low T levels by up-regulating the number of (or activity of?) androgen receptors. So, each such cell now exposes many more receptors to the same (very low) levels of physiological T…resulting in the same amount of T brought into the cell, as if there were normal levels of T. This adaptation is the beginning stage of castrate resistance, i.e. tumor progress despite low levels of T.
At that point (continuing with my own understanding here), introducing supraphysiological levels of T (i.e. BAT) overwhelms those upregulated ARs…and then for some reason that I don’t yet understand, the tumor is re-sensitized to ADT and patients can engage in ongoing bipolar cycling.
But, how would that work if one is not developing CR yet? What effect does the additional T have on normal levels (either number or activity) of AR?
I’m sure I’m misunderstanding something here. Thanks for taking a moment.
Very high T levels (2000+) suppress PC growth and kill it via inducing double stranded DNA breaks, among other mechanisms. It does not depend on nor work only for CR populations. That is why BAT actually does work well in mHSPC as many of us have demonstrated and was shown in Schweitzer’s small trial. You are correct in the theory that AR will be amplified rapidly during the low T phase and possibly make the cancer even more susceptible when high T is resumed.
That is the protocol that is being tested by Nat Lenzo in Perth. Two doses, two weeks apart. Split to have reduced impact on marrow. PSMA visible oligomets were first treated by SBRT. Since Lu-J591 molecularly targets unseen micromets and possibly also individual circulating cancer cells, that is why I called it a clean-up treatment. It is purely experimental in this regard.
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PSA rising on BAT
