Bicalutamide is supposed specifically to block metastatic cancer cells Testosterone receptors to starve them of their growth potential. Even so, testosterone has many additional functions, one of which is to produce and facilitate muscle growth and maintenance of the same. I have lost a lot of weight on my current ADT Biacalutamide regimen, 20 kg (about 45 lbs) in just about 3 1/2 months. I have asked my oncologist if there is any benefit to adding a SARM, like Enobosarm (Ostarine) or other, and am awaiting her response. I follow Keto, although not strictly, and train hard but am seriously afraid that I am loosing not only fat but muscle mass. Hence my question!. Anyone had similar thoughts or experiences from SARMs in conjunction with Bicalutamide?
Bicalutamide and the way of Testosteron - Advanced Prostate...
Bicalutamide and the way of Testosteron
Are you exclusively on Bicalutamide, because the term ADT is used to denote Luprolide. If yes, you may try the Minimum Effective Dosage instead of the standard 50 mg/day or 150 mg/day in some countries for monotherapy. I have been on 1/10 (25 mg/5days) the standard dose for 3 years without loosing any weight, which I would have liked.
Many thanks for dropping these lines Justfor_. From my horizon ADT encompasses quite a few substances used for Androgene Deprivation Therapy. That set aside, Yes I am on my third Bicalutamide treatment and responding fairly well so far but have lost a lot of weight during a short period. A little bit scared of loosing muscle mass as I am not an any way obese. Your Minimum approach to SARM regime looks very interesting and just wonder if it is Osterine?
No SARMs for me. What I do and take is documented here:
I have been on SARM's for 2+ years now(Osterine) with approval of my MO. gained considerable amount of muscle over that time. 185lbs without SARM"s looks horrible compared to me at 195lbs on SARM's. When administered properly, paired with a good workout and diet, muscle growth is very possible. I began to see results at about 6 week mark.
Thanks mrscruffy. Valuable points especially when you had the approval of your MO. Went from about 175 lbs after radiation in 2021 to 195 lbs in a few months. Now on Keto, Training and Bica and lost about 44 lbs (weight now more or less 150 lbs) since the beginning of July. Are you currently on any other medication specifically for PC/MPC? If so, your MO mentioned something about doing Bica and Osterine at the same time?
I did Lupron/Zytiga for 8+ years until it failed, I am now on Lynparza. I cyle the Ostarine every 6 weeks to prevent any kind of problems. Oddly enough Ostarine was designed for Prostate cancer and gave me an extra year when ADT started to fail. At least that is what MO believes.
You wouldn't use both. Bicalutamide blocks androgen receptors on all cells (PCa, muscle, etc.), so there is no point in using it together with a SARM.
Without going into any polemics here on the forum is there any, to your knowledge, publication made on this topic? No matter if it´s Bicalutamide or any ADT that have been simultaneusly administrated?
It would never be tried because its counterproductive to combine them. Trials have to make sense. There have been trials of SARMs alone in men who have already had curative therapy.
That is really the issue. I understand that SARM stands for selective modulator of androgen receptors, but is it really true that Bicalutamide has the same effect on all cells receptors? As Testosteron has so many versatile functions I think that the question is legitimate even though as you say it doesn´t make sense, still no simultaneous trials.
People who understand biochemistry would not be interested. Bicalutamide prevents activation of the androgen receptor on all cells. You might want to read a textbook on biochemistry.
I am a Biologist
You may want to review some basic texts, then.
Nothing is only black or white. It´s like saying cancer can only be explained to be a thing derived from mutations which we now had as pardigm for at least 50 years. How can anyone cathegorically say that because "basic texts" say something this has to be 100% true?
You obviously don't understand how the AR works, what anti-androgens do, and its ubiquity.
I think noone does in full
I take your point. However, from a theoretical standpoint, given the lack of empirical data, we can assume that use of both drugs simultaneously will result in competition between the two drugs for androgen receptors. Given that Osterine has a beneficial effect on eg muscle but apparently no downside on PCa, it does not seem a wild speculation that the right ratio of the two drugs might just work - ie inhibit ca growth while giving muscle some protection.
The key is the relative binding constants of the two drugs on the androgen receptor in different tissues and their relative bioavailability in vivo.
This may be pie in the sky but until the experiment is done we cannot know.
That's my point(s) too, not get categorical denial that serves no progress. My question from the very beginning was not if it is even possible but if anyone has experience using Bicalutamide and SARMs at the same time. Perhaps I expressed myself somewhat unclearly at the beginning. Thank you, Doc.
No, we know. Bicalutamide blocks the AR and prevents activation by testosterone and other androgens or SARMS. It is not competitive with anything. If it were, the increase in serum testosterone (because the testosterone has nowhere to go) would "compete" with the bicalutamide for the AR sites. No one would consent to give you both.
bicalutamide has relatively weak affinity for the androgen receptor and binds reversibly. Thus another agent (eg SARM) which can bind with the same receptor could compete with bicalutamide. So the effect of each in vivo would depend on their relative affinity for the receptor.(amongst other factors).
A simple in vitro experiment would answer the question in principle and as far as I know this has not been looked at.
Other drugs such as enzalutamide bind much more strongly to the AR.
As far as actual clinical practice is concerned it is true that in the absence of data a clinician is unlikely to prescribe a SARM with Bic . The SARM might well ablate the effect of bicalutamide. But bottom line is we just don’t know.
I agree that bicalutamide is the first gen of antiandrogens and there are much better ones now. Then what would be the point of taking one medicine to undo what another med does?
Well, as I understand it, the question is whether a SARM which purportedly does not drive the prostate androgen receptor, could be used to protect bone and muscle while avoiding interfering with Bic inhibition of the PCa androgen receptor. Hope I have understood correctly.. I think it is an interesting question and one I don’t think we can answer with certainty. It is also one I have been thinking about for a while. After all there is the same issue in breast cancer with SERMs.
Sorry I should have also said that I agree Bic competes with testosterone and presumably has a higher affinity than T. And yes indeed Bic binds to AR in all tissues (as far as I am aware).
When I said relatively weak I meant in comparison with newer agents - Enz, Apal etc
Thanks, that's exactly the kind of information I'm looking for. It would be great of you if you could provide me with scientific studies or is it just taken for granted that these drugs will be antagonists and that no one ever bothered to do animal studies to begin with? I'm really not trying to be sarcastic.
Lots of studies were done.
Good day . I don't take the same drugs but I am on hormonal therapy since last November and take Extandi pills 0f 160 mg each day and a Reseligo injection in my stomach for custraition every three months . My PSA dropped from 155 to 2.5 in 10 months which is very good . That is the good news . The bad news is that there are many side affects that go with these drugs . You can read about them in the NET . I just want to tell you that I too lost lots of weight and have no strength anymore . Till a a year ago I used to split two truck loads of firewood by hand and had no problem at all . This year I couldn't do that and had to buy wood spliter . Just had another test done a few days ago and things are looking good thank God . I asked the Doctor if we can cut down on the drugs and he said that is a NO NO ! I will have to keep on taking them for life he said and pray that things don't get worst because cancer sells have way of overpowering the drugs . I am 69 years old now and end of November I will be 70 if I am still alive . Wishing you good luck and I hope that I was of some help . Take care
As I am still, after RT in 2021, still on Bicalutamide and want to stay on it as long as possible. I so far feel great this 3rd time and Psa is dropping fast from 8.8 to 0.5 since 10th of July . The first 2 times was horrible and the doctor advice was to lay off and he remarked "the drug can kill men". I started with a Keto diet at the same time as this last bicalutamide but am concerned about my rapid weight loss. Thanks a lot bowmasterguy, I hope you will live long into the 80th or more. Take care my friend.
Losing 45 lbs in 3 1/2 months is, in my opinion, too much to have been solely caused by bicalutamide monotherapy. Far too much. Do you have co morbidities of any kind? How much are you eating? What does ‘train hard’ mean specifically?
Yes, losing 45 lbs is a lot but I feel good and morbid thoughts have nothing in common with me. I ride about 200+ km a week when possible and this is not very much by my standards as a former elite athlete. For others it may be excessive, can agree to that . I feel good after training these shorter distances today as well. The main idea now is to stay below the lactate threshold so as not to produce too much of it to in turn avoid new glucogen production eventually to be used to fuel metastasized cancer cells. My only concern is my weight loss, I'm eating ok on the Keto diet I started at the end of June along with the Bicalutamide regimen. So now you know!
Excellent on the biking. So you are on Bicalutamide only? What is your testosterone level?
Fluctuating, so far not lower than 10 and not higher than 20 nmol/l since 2022 - May 2024 and during that time been on my 2nd Bicalutamide from abt June to Nov 2024 Will do another at end of this month after having my 3rd Bicalutamide since 2nd of July
Lifting weights/resistance training in general is a must on ADT unless you’re ok with substantial muscle loss that you’re unlikely to ever restore. This is true for all older people, not just us. With all your dedication to biking, adding some weight lifting and more food is relatively easy and would likely produce the desired changes quickly.
I'm struggling to maintain a healthy weight and keep gaining belly and moobs fat...My diet is not consistent.
I go gym, weighted exercise.
Muscle is there under the skin suit!!!
I walk, im fit.
I struggle with diet and also question if biculamide as a mono therapy would be better at keeping my PSA numbers down and then not constantly creeping up.
So you don't have the lupron injection and just have biculamide???
Your bio?
What was your gleason score were you advanced
Have you still got prostate.
And I've spoken about sarms over last few years...
My simple understanding of sarms is they help any testosterone get to muscle quicker n easier(if there is any testosterone...
In 2021 I was treated for T3bN1M0/Gleason 4+5=9, my Psa when just days before RT was around 40, also considering beeing administred Finasteride which has to be in mind. My prostate was not removed as the cancer had grown extraprostatic and had messed with the nerves nearby. For me the option of radiation was quite a natural choice and truly the only way to try to minimize collateral damage.
Here are some dates and values in consecutive order;
8.3.2021 18F-NaF-PET-CT : no bone metastase.
9.3.2021 F-18-PSMA-PET-CT : Right lobe and suspicious left
apex uptake, N1, pe3 Gy, prostate and seminal vesicles 49.4 Gy.
12.3.2021 FIRMAGON 240 mg s.c.
12.3.2021 BREAST prophylactic single irradiation 12 Gy 9 MeV.
12.3.2021 BICALUTAMIDE 150 mg x 1 for 6 months.
17.3. - 15.4.2021 VMAT RapidArc radiotherapy, LNs 44 Gy , PSMA + ad
60/3 Gy, prostate and seminal vesicles 49.4 Gy.
9.4.2021 FIRMAGON 80 mg s.c.
19.4.2021 1. HDR Brachytherapy
3.5.2021 2. HDR Brachytherapy
2.7.2021 NADIR PSA 0
17.5.2023 PSA 3.5 as a possible sign of relapse of the cancer.
01.06.2023 Ga68-PSMA-PET-11, shows NO Mets
02.06 2023 Started BICALUTAMIDE 150 mg, 6 months, ended Nov 2023
20240530 18F-PSMA-PET-1007, shows NO Mets
20240701 NaF-PET, shows NO Mets
20240702 DCFPyL-PET Surprisingly 10 Mets shown of various sizes, ie only a month after 18F-PSMA-PET-1007 showing nothing. Starting Bicalutamide the same day and now monitoring Psa every 4 weeks. Now down from 8.8 on 10th of July to 0,5 on 25th of Oct.
Now, I struggle to just like you to keep up with healthy eating, I am pretty cautious to not starve myself though, trying to regulary do aerobic ( sometimes not possible to avoid passing the anaerobic, ie lactate, treshold) workouts on my bike. I am doing ok and feeling quite ok but worry about loosing to much weight. I am not a "couch potato" in it´s specific meaning
I only use/d Bicalutamide, except for 2x4 Firmagon shots I had in 2021 in conjuction with my RT. I hope I can stick to this along with my moderate Keto, avoiding as good as I can rapid carbs to fuel my metastases. I will not comment on SARMs ( Selective androgen receptor modulators are a class of drugs that selectively activate the androgen receptor in specific tissues, promoting muscle and bone growth while having less effect on male reproductive tissues like the prostate gland. True or not I don´t know, the short text is from Wikipedia so take it from what it´s worth ) as this seems to stir the pot a little bit too much, but it is, and still being used for muscle enhancement. All-in-all, this was an attempt for me only to find out if anyone had been doing Bicalutamid and SARM at the same time.
I hope you found something useful. I am not a doc, just in the same boat as many of us are, and I certainly am not here to write on someone´s nose how to find a way with this complex issue that PC is. Still, do not let couriousity kill "the Cat".
Take care Brother Troxely
My interest was in your biculamide cassedex.
Biculamide drove my PSA down Initially, but it's slowly creeping up...
So just seems like common sense to me to try biculamide just to see...
Lupron works differently to achieve same thing.
Don't think any harm in trying it.
I'm gonna snuff it any way, so why not, ah, but first I need to get my NHS oncologist to say it's ok!!!
Same with sarms
There's few guys who tried stuff.
It's good to try, but not trying selling it as the fix
That sounds risky to me. Thinking it would not do much but if it did might diminish the effectiveness of the drug. I was on ADT and abiraterone for 2 years. I lifted weights twice a week and exercised and I managed to keep my strength and weight constant. Your weight loss is very impressive. I don’t think anyone could lose weight the fast without losing some muscle. You don’t mention what you body looked like before the meds. Were you overweight? Were you a muscle bound weight lifter? What happened to your appetite? Did it change. Did you change your Alcohol consumption.
Those are some very thoughtful questions Gramps. I take nothing but Bicalutamide and my type of Keto is not 100pct strict. Of course the extra beer is now banned but the occasional glass of wine or two is still included along with some red meat. Yes, I was at a not so acceptable excess weight since my radiation in 2021 ie from about 175 lbs at the time of radiation in 2021 to 195 lbs a few months later. Now, as I said before, on Keto, Training and Bica I lost about 44 pounds (weight right now more or less 150 pounds and I consider my ideal weight to be 160 while a few extra will do during wintertime) since the beginning of July. And, as you so clearly point out, my mind will naturally revolve around the question of muscle loss, but being as active as I could possibly be for all these years, I can't really figure this out other than to blame it on Bicalutamide blocking not only metastasized cancer cells PSMA but also muscle receptors. "Whishing" for some sort of difference in pathways and affinities in the comparison of cancer cells and working muscle cell receptors in their search and consumption of energy.
"ADT Biacalutamide regimen." Do you mean you're using Casodex in conjunction with Lupron? HUGE difference in effect on testosterone!!
Never said that, only using Bicalutamide aka Casodex
I see others shared my question about that remark. Me, too. My doc took a look at me and checked my blood and decided not to Lupron me but leave well enough alone with only Casodex (it's easier to write than Bicalutamide ;-). If my numbers change, she'll go with Lupron/equivalent on an intermittent basis. I feel great now - working out and walking and generally have good energy - so I was not overly enthusiastic about destroying my testosterone. But if the numbers change (PSA rising from its current 9) or my swollen lymph nodes return, it will be time to put that pink tutu and stiletto heels on layaway, I guess. 
After reading this whole thread I would surmise that you received the answer to your question.
Perhaps posting your question at a latter date might receive a different audience on the forum. You have to remember most posts are limited to a snap shot in time and the limited audience you are attempting to reach may not be active at that time.
One other thought. Since you are a biologist perhaps you might try posting your question on one of your more frequently visited bio/chem forums that deal with the more scientific aspects of your question. Even though not specifically related to PC they can perhaps be more specific about the physical properties that may allow you to derive your own analysis.
Hope that helps.
There's a free Kindle book outhere tittled Adaptive Bipolar Androgen Therapy for Prostate Cancer. I'm not suggesting anyone what to do, other than perhaps read it and form your own opinions. The book is basically a summary of thousands upon thousands of hours of research on different prostate (and other) cancer protocols, meds, etc., all linked to peer reviewed studies, as well as the author Russ Hollyer, personal experience. It is not just a one sided presentation, and this is one reason I recommend having a look. The other reason is the author is a NASA engineer, so he likes to analyse data, not just spew nonsense. You will find the most beneficial Sarms for hormone driven cancers are those with the lowest ratio of androgenic/anabolic effects , such as Ostarine. The reasons why they should not be taken with Bicalutamide have already been stated on another response. It would be different with an antagonist such as Orgovix though.
Bicalutamide?
Zoladex + Bicalutamide
Bicalutamide Vs Eligard
The importance of training your legs (if you can, of course)
