Hormonal injections and oral hormones

[tarzantass]

Hi guys, we talked so much about oral hormones like Casadox, Xtandi, etc. being castration resistant. 1. Can hormone injections like Lupron, Zoladex, etc. be also castration resistant? 2) if Lupron or Zoledex can be castration resistant, how do we know which one — hormonal injections or oral hormones— is castration restriction? 3) let’s say Xtandi I am taking now is no longer effective, if I change to Zoladex from Lupron I am currently using can Xtandi can be effective again ? Appreciate all your responses and thanks.

[Justfor_]

No! Both deprive cancerous cells from their energy source T. They accomplish this via different paths, but the end result is the same. When the new cells are independent of T castrate resistance sets in. There are two ways to gain extra time. Both are NOT SoC though. First is BAT. You fight the T independent cells by a storm of T and squeeze them by an army of T sensitive cells that can be deactivated later. Second is to use only as much of the medicine as necessary to establish an equilibrium. The hope is that by not overdoing it it will last longer. I am doing it with Bicalutamide user Stoneartist does it with Enzelutamide. Not possible with depot injectable substances. Your call.

[tarzantass in reply to Justfor_]

I am not quite sure whether you answered my questions correctly. Thanks

[cesces in reply to tarzantass]

He actually did answer your question very eloquently actually.

Read it a few more times.

It's the cancer that becomes resistant to treatment via reduction of testosterone.

[Tall_Allen]

1. Yes, of course. Castration resistance means rising PSA or metastases while taking Lupron, Zoladex, etc.

2. If the cancer is castration resistant to a second-line hormonal taken along with Lupron, etc., it is resistant to both.

3. If your cancer is castration resistant, it is resistant to all means of physical or chemical castration, Lupron, Zoladex, orchiectomy, etc. They continue to lower testosterone. But it is more important than ever that you continue to use them. Your cancer has become super-sensitive to even the smallest amount of testosterone.

[tarzantass in reply to Tall_Allen]

Thanks Tall Allen. Could you please explain Point 3 again Thanks

[Tall_Allen in reply to tarzantass]

What part don't you understand?

[tarzantass in reply to Tall_Allen]

“But it is more important than ever that you continue to use them.”

[Tall_Allen in reply to tarzantass]

One of the reasons for castration resistance is that the androgen receptor multiplies, so that even the smallest amount of androgen can activate it and cause replication. It is more important than ever to minimize testosterone.

[tarzantass in reply to Tall_Allen]

So you are trying to say despite the castration resistance, Lupron or others still has to be administered, right?

[Tall_Allen in reply to tarzantass]

Of course.

[Tinuriel in reply to tarzantass]

Our MO explained that some cancer cells remain sensitive to lower testosterone, they don't all make the jump to castrate resistant at once. Maintaining ADT keeps those cells at bay, which helps the overall situation.

[tarzantass in reply to Tinuriel]

Thanks.

[Tall_Allen in reply to Tinuriel]

ALL PCa remain sensitive to testosterone. However, they are activated even without it - more easily with it, which is why you still have to prevent all testosterone.

[Tinuriel in reply to Tall_Allen]

Thanks for clarifying, TA!

[Rickmartin1948 in reply to Tall_Allen]

very interesting TA I had never seen it that way

[tarzantass]

Thank you so much.