another undetectable

[Brysonal]

PSA in again at undetectable which I am assuming means my testosterone is not recovering . No T result yet but 0.5 last month!

Still on Apalutamide as a monotherapy but coming off that too is bouncing around my head. Would love to go med free,

still watching all developments and still no idea of the OVM-200 vaccine e did trigger an immune response .

anyway just an update and an hello from England to you all.

[Ian99]

Wow, reading your profile was like War and Peace! Hats off for taking this on in such a full on manner. I hope you’re also taking time off to chill periodically. Good luck.

[KocoPr]

excellent work! Thanks for the update

[Maxone73]

fight on!!

[cujoe]

Brysonal - As always, Grazie for the continued updates. BTW, as with bicalutamide mono, your T should actually get a boost (sans any other form of ADT) from the Apalutamide - as per the following passage from the paper linked below:

"Apalutamide, an androgen receptor inhibitor, is an ideal compound to evaluate in this population given its proven antitumor efficacy in men with advanced prostate cancer and the fact that it does not impair the hypothalamic-pituitary-gonadal axis.14,15 Indeed, as a consequence of a negative feedback loop, single-agent therapy with apalutamide results in an increase in testosterone levels." (Emphasis added)

I can vouch for a similar T-boost for AR inhibitor bicaLUTAMIDE, as it (along with alternate-day dutasteride) has boosted my T to a 700 to 800+ range over the last two years. That amounts to about a 50% average increase from the off-treatment levels in the several years prior. There are very good reasons that men have T - and when yours goes back up, you will remember why!

Here is the link to the paper mentioned above:

Pathological Effects of Apalutamide in Lower-risk Prostate Cancer: Results From a Phase II Clinical Trial, The Journal of Urology, Volume 209, Issue 2, February 2023, Page: 354-363.

auajournals.org/doi/10.1097...

Stay positive, while continuing to remain both Safe & Well,

Ciao - cujoe

[Justfor_]

I have repeatedly witnessed T counts in the 2000-3000 range by taking Avodart and Bicalutamide. My untreated T was 800-900. Reducing Bicalutsmide dosage to half a tablet every 5 days brought my T "down" to 1600-1800. All endogenous if you please.

[cujoe in reply to Justfor_]

Justfor_ - Your results would seem to put you well into the Hero-Greek-God class of "Good Responders" to the "lutamide" ARi and 5-ARi combo. With those sorts of T-levels, maybe you have defined a new BAT strategy for consideration by similar good responders. I'm currently considering doing a single month lupron in late May as a adaptive shock to the PCa gremlins. Current QOL is excellent, so the thought of even a temporary disruption is weighing on that decision. I'll likely do another male hormone panel between now and then to push me one way or the other.

Trust all is well with you and the family. Keep it that way, Amigo. Ciao - cujoe

[Justfor_ in reply to cujoe]

I have the suspicion that the Estrogen lowering action of Tamoxifen and the same on blood circulation of the Beta blockers I also take, both act synergistically with that of the ARis in impending the energy supply chain to the cancerous cells.

[cujoe in reply to Justfor_]

The following is mostly "just for" Justfor_?

You've answered a lingering question I had about your supraphysical endogenous T levels; i.e., what about the elevated E2 that would likely result from such a high T? = your use of tamoxifen as a pharma agent to "selectively" mitigate. As you probably already know from my earlier posts/replies, after starting tamox as pharma "bridge" to breast RT for gynecomastia about a year back, I chose to continue with low-dose (5 mg daily) along with the bical + dutasteride regime. My PSA has settled in at 0.2 +/- over the last year or so, and while that is not "undetectable" or very close to my original target (<=0.05), this low-cost, 3 generic drug treatment has allowed me to have high-normal T to rebuild muscle-mass lost during COVID, along with T-related benefits for maintaining an active lifestyle with excellent QOL over the last 18 months. (We all know the multitude of health benefits that rely on T - and are mostly lost when on ADT.)

I'll probably eventually get around to posting about the use of SERMs, like tamoxifen, for treating PCa. In the meantime, I'm linking a paper about the use of MSM with tamoxifen in BCa. It targets the Jak2/Stat5 transcription pathway that is also active in PCa. MSM is cheap supplement (I use the powder) that can act to boost tamoxifen's efficacy, while providing other health benefits. I've included links to the MSM+tamox paper and several links about the relevance of Jak2/Stat5 to PCa.

The combination of methylsulfonylmethane and tamoxifen inhibits the Jak2/STAT5b pathway and synergistically inhibits tumor growth and metastasis in ER-positive breast cancer xenografts, BMC Cancer, (2015) 15:474

bmccancer.biomedcentral.com...

Second-Generation Jak2 Inhibitors for Advanced Prostate Cancer: Are We Ready for Clinical Development?, Cancers (Basel), 2021 Oct 17;13(20):5204.

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

Genetic evidence supporting a causal role of Janus kinase 2 in prostate cancer: a Mendelian randomization study, The Aging Male, Volume 26, 2023 - Issue 1.

tandfonline.com/doi/full/10...

Also, I recently had some rather disturbing vision issues (after a detached/torn retinal repair and cataract surgeries back in 2020 restored me to 20/20 x 2). In researching possible causes, I discovered that all three of the drugs I (we?) currently use CAN cause vision problems, with tamoxifen seeming to be the most concerning; re: retinopathy and optic nerve damage. Fortunately, my issues were related to clouding of the rear portion of the lens capsule after the cataract surgery. (A common occurrence, BTW.) A simple laser removal of the central portion of the clouded capsule (aka YAG procedure) solved the problem almost instantaneously and restored the excellent vision I had experienced after the cataract surgery. However, as a much younger individual that me, it would definitely be in your best interest to have regular eye exams and be on the lookout for any drug-specific optical changes, esp. since some of the "changes" are irreversible.

Μείνετε ασφαλείς και να είστε καλά!

Ciao - Capt'n cujoe

[Justfor_ in reply to cujoe]

Thanks for the useful info. Three times I have tried to lower Tamoxifen to 5 mg/day and within a week my breasts turned sensitive. After your info I will try it again along with MSM. What brand are you using? TIA.

[cujoe in reply to Justfor_]

I don't really thinks it much matters, as long as it is from a mainstream supplement company. I'm currently using the powder by NOW and add it to my daily smoothie. Their recommended dosage is: "Take 1/2 teaspoon (1.8 grams) 1 to 2 times daily in juice or oother liquid. If intestinal gas occurs, reduce dosage." (With all the fiber I eat daily, there was not much chance I was going to have that problem.)

In addition to the 2+ grams of MSM I add to the smoothie, when taking my 1/2 tab tamoxifen at night I toss about 1/2 teaspoon of MSM in a glass, add about a teaspoon of flavored protein powder, then some non-dairy milk, mix until dissolved and then use it to wash down the 1/2 tamox tab. You might just want to get MSM in tablet form and pop the two pills together. I have not tried to proportion the dosages based on the research paper. It seem a safe supplement at any reasonable dosage, so I'm not overly concerned about overdoing it.

I actually started first using MSM some years back. I seem to remember posts by Nal and/or Patrick about it, but fail to remember to context. I considered it then more for joint/osteo benefits and took a cap that combined it with glucosamine. I see more research now on it being used as a companion to pharma drugs for various cancers. That is how I came upon the article about it and tamox in BCa that got me adding it to my daily supplements again.There is more out there in the research, if you want to look for it.

In the past I used Dr's Best OptiMSM which is GRAS-designated. Not sure why I switched to Now, but will likely go back to that or another OptiMSM supplement next time I order.

In general, I trust Dr's Best, Now, Jarrow, Life Extension, and Nutricost from the listing I got for MSM tablets on Amazon. Most of them also offer MSM in powder form.

My attitude has been that it might improve the effectiveness of tamox at best, and at worse should provide some assist to bone/joint/gut health while reducing inflammation. Here is the link to the Examine page on MSM:

examine.com/supplements/msm...

And the one from the mfg of OptiMSM:

balchem.com/human-nutrition...

I've just recently started the concurrent dosing with tamox at night, so with uneven spacing of prior daily doses, I might not have been getting the potential positive synergy of the combo. I was somewhat miffed by an elevated E2 (out of normal range!) in the face of a lower T at my last hormone panel lab, so I'll do another panel around the middle of next month (prior to my end of May MO visit). That should give some indication of any positive impact from the regularly concurrent dosing. I'm not expecting any changes to meds or supplement before that lab, so any major move in E2 would more likely be a result of the more carefully timed dosing. Look for a heads-up when I get those results.

Probably more than you wanted/need to know, but in the end, MSM seems to be a fairly inexpensive and SE-free supplement that offers potential benefits in several areas related to various cancers and other areas of human health. Added to the large daily dose of sulforaphane I get from broccoli sprouts and I don't imagine that I am ever going to be deficient in sulfur compounds.

Good luck with the combo. I hope it works to let you reduce the tamox dosage. As you are living proof, Less really can be More!

Stay Well - Ciao - CJ