BAT treatment

[VonKantarellen]

Are there any data available on BAT treatment given to prostate cancer patients with a weakened bone marrow with low platelets and low red blood cells? If not does anyone have any thoughts on this?

[GP24]

BAT adds testosterone to your standard ADT. This will not weaken the bone marrow.

A weakened bone marrow with low platelets and low red blood cells is a very bad situation.

[Tall_Allen]

Testosterone stimulates red blood cell production. But if the bone marrow has been damaged by the cancer (which is likely if platelets are low), testosterone may stimulate the cancer and make the situation much worse.

[Ramp7]

urotoday.com/video-lectures...

I would suggest you reach out to Sam Denmeade at John's Hopkins.

Bone pain usually prevents Denmeade from using BAT on his patience but I do know of an individual with bone pain that weathered the flare after Testosterone and is responding favorably to treatment.

[85236442968]

VonKantarellen

After reading your post I took the time to do a little research on BAT as i knew very little about it. I know now a little about it but not a lot. I did however find a informative article at,

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

It is a patients guide to BAT with the complete abstract of a study.

I hope it helps.

[katartizo61 in reply to 85236442968]

good article, thank you

[OsloN in reply to 85236442968]

BAT is important, but the cycling between BAT and ARSi like in the STEP-UP trial is the real game changer. I get this treatment at the Radium hospital in Oslo.

[Chris_Ali]

Hi, Did you ever pursue BAT? My husband (castration resistant and tried ever treatment) checked into the hospital 10 days ago for intense bone pain that requires heavy morphine. He has weakened bone marrow with low platelets and low red blood cells. He's getting palliative radiation to lower pain in a few places. The hospital team says we can consider hospice next. But I'm considering starting BAT with him although his oncologist disapproves. I feel like we have nothing lose except it may cause him more pain. But he's on so many painkillers now anyway. He's going to die within the next few months and BAT may have a slim chance of buying him more time. Plus making him feel better because of testosterone.

[VonKantarellen in reply to Chris_Ali]

Hello! I’m sorry to hear about the situation about your husband. His situation seems to be exactly like my dad. Low platelets, low red blood cells and bonepain. Given up by all doctors and started on palliative care.

We were also adviced to stay away from BAT. The doctors at the hospital told us that it would kill him in a few days/ weeks and that this kind of treatment don’t work. We did despite that start BAT on our own because we felt that we had nothing to lose. Im a doctor myself, but I work in a different field so I prescribed him testogel 100 mg twice a day for 28 days. Level of testosterone should be above 2000 ng 4-6 hours after applying. We gave him this dose for 28 days.

Now PSA is down from 64 to 57 (He also got radiation therapy 5 weeks ago which can effect this value) We do only have access to Bicalutamide to block testosterone the next 28 days and we will take a new PSA 14 days into the cycle. Bicalutamide is not as effective as Enzalutamide and Darolutamide, but some people use it and it works.

Considering that our oncologist told us to stay miles away from BAT, this has gone extremly well. He got a little bitt extra tenderness in his breasts that bothered him a little for some days but this is normal from the treatment. Part from that I would say no extra pain related to the cancer. He is on Morphine tablets now 10 mg twice daily. Under BAT treatment he also got an infection and was hospitalized for 2 weeks. CRP above 300, but we did not stop the treatment and that went quite well. Last days of cycle he started to have more movement in his legs that is weak because of his cancer and he could actually walk again. Only for 10-15 meters before he was out of breath, but this is still progress. He only got radiation to his shoulder 5 weeks ago so somehing positive might have happended.

We don’t dare to have any big hopes yet, but the PSA and his condition the next weeks will show if this treatment will work or not. But Im optimistic because we feel that his condition has started to be a bit better actually the last 7-10 days. We have an apointment with the hospital that he will get platelets and blod transfusion when he needs it. Hopefully this can keep my father alive for some time to see if the treatment will have effect.

I don’t want to give you any false hope for your husband, but just before we started treatment they told us it would be his last weeks. Now my dad is better, but still in a weak condition. As long as he gets his nutrition in every day and transfusions he can still be here for a long time. If the treatment works we hope to see a drastic improvement the next months.

Please feel free to ask me any kind of question if you have some. Best wishes!

[Chris_Ali]

Thanks so much for getting back to me so quickly. That is amazing to hear about your father! I just want to make my husband have more time and better QOL. So was your Dad on androgen deprivation hormone blockers before he started? Did you measure his testosterone after applying the gel or did you know that that amount of gel would get the effect? Is there only one kind of Androgel?

How old is your dad? my husband’s only 64 so that might make a difference. I’ve talked to our oncologist into giving my husband LD a testosterone gel, but I’m not sure how much he will get. He’s in the hospital currently in the nurses will administer.

I spoke to someone on the site who successfully administered BAT to themselves and used injectable testosterone that is no longer sold in the US. But if testosterone gel could work, then I would love that. So much less daunting to administer.

I can’t tell you how much I appreciate your answer to my message. I’m determined to try to help my husband no matter what.

[OsloN in reply to Chris_Ali]

It is crucial to understand the mechanism on the cell level if this treatment will work. During ADT the cells adapt by increasing the AR expression, 30 to 90 fold by copying itself in the cell membrane. Even though T level is low the cells have enough for a sucsessful DNA replication, CRPC is developped. Using high level of T (BAT) the cells adapt in the opposite direction, removing the copy gain, returning to the basic level. Then there will be resistance to BAT, high T and PSA will rise rapidly. BUT, now the cells are resensitized, then you block again. Prof Denmeade at Johns H have a trial now doing precisely this.

I have been on this AR back and forth game for a year now, a dynamic approach. ARSi Darolutamide brings the PSA down to 0.15, then I deliberately increases PSA to 4 over the next two months. Insane says everyone except my MD, he KNOWS that these cells are highly sensitive again. New round of Daro - Denmeade describes this as a continuum. How long can you do this? Nobody knows yet, maybe an indication in 2025.