BAT therapy/muscle pain.

[Aldo62]

Has anyone had experience with muscle pain while doing BAT therapy?

I have 4th stage prostate cancer and I have been doing Nubeqa and Orgovyx this year.

My PSA has been slowly rising, going from a low of 3.9 in July to 7.3 in October.

I am trying to resensitize the cancer cells to the ADT using BAT therapy

(one shot of 400mg cyprionate Testosterone for a month, then crash the T with Orgovyx and Nubeqa for a month, a washout of 7 days, then start again)

I talked with many people who were having success with this, but I am experiencing muscle pain in my back, close to T5 where I have a met. Makes it hard to go about day to day work.

Has anyone had this happen? It reminds me of the severe muscle pain when I first had Lupron, but it is lasting longer.

[KocoPr]

have you had a scan lately?

If i were you i would stay on nubeqa and orgo till you get your psa way down to either undetectable or close to it.

My mistake was to not do that when my PSA was slowly rising on both cycles till the high T cycle got around 3.xx then spiked to 6.xx in a two week period. See my post below

healthunlocked.com/user/Koc...

i think we all have to find our own oh crap point and then temporarily jump of BAT to reset our PSA which is exactly what I am doing and last checked my PSA was dropping like a rock.

My OC was very confident my two bone mets will be killed by daro and orgo soon. He was very happy to see that after 1 1/2 years on pBAT that all my previous lymph mets above and below abdomen were gone.

[Aldo62 in reply to KocoPr]

Thanks for the reply. I am probably due for another scan, but my last one looked fairly good, with my hip met nearly gone. My understanding is that the whole point of BAT is to resensitize the Cancer cells. I have been on Nubeqa/Orgovix for nearly a year. My PSA never went down to undetectable, so I don't think that combo is going to get me there right now unless I can resensitize. Feeling a little better today.

[KocoPr in reply to Aldo62]

I should have said your NADIR not undetectable. For me it was undetectable at 0.02 after 1 year on nubeqa and orgo.

[Aldo62 in reply to KocoPr]

Yeah, I never ever got there.

[KocoPr]

is your psa still going down on ADT or are you castrate resistance?

[Aldo62 in reply to KocoPr]

No, I have been doing Orgovyx and Nubeqa all year and I am starting to get resistant. It is creeping up slowly. 7.3 last time I checked

[KocoPr in reply to Aldo62]

You should get a liquid biopsy to check for new mutations. Guardsnt360 now texts for over 749 genes and is covered by medicare.

[Bjry]

I was in a BAT trial and had 4 doses of very high testosterone without any muscle pain. BAT did not resensitise me to any previous treatments.

[Mrtroxely in reply to Bjry]

How did you feel while on the bat treatment?Better, worse, same, other???

[KocoPr in reply to Mrtroxely]

I did BAT for 15 months and it did wonders to my skin, mental health finally having estrogen in my brain and of course muscle growth and NO joint pain. It also kept the beast happy on androgens so it didn’t need to mutate. The trick is individually finding the balance between to keep your beast in check and it escaping

[Aldo62 in reply to KocoPr]

So, did you stop responding to BAT after 15 months?

[KocoPr in reply to Aldo62]

i posted my BAT response (link) in my first post on this thread. It explains it well.

But to answer your question hmmm my cancer was responding well to high testosterone it loved it but it took a year before my cancer started growing on T.

I did BAT for QOL AND to delay drug resistance. So the unanswerable question is was when i started BAT was it just in time to stop my cancer from finding a way around daro/orgo treatment? The only answer i can give is maybe, but i do know for certain that i kept my cancer to love testosterone. I rely heavily on the ADT cycle to knock the cancer down and high T to keep the cancer fed so it won’t go resistant.

I hope that makes since.

[Ramp7]

I did BAT for 10 months. Having T in the blood stream was very positive to QOL.

[Aldo62 in reply to Ramp7]

Good to know. That's what I hoped , but this initial week has been very difficult for me as my body adjusts. Are you still on it?

[Ramp7]

Unfortunately I stopped responding to BAT after a while. I had to move onto Chemo at the present. Checking into immunotherapy. Is BAT still in the future, maybe.

[Aldo62 in reply to Ramp7]

Sorry to hear that. Where were you when you started? Had you done surgery or any serious interventions?

[Ramp7 in reply to Aldo62]

It's a long story going back 17 years. My goal is to live with this as long as possible, along with QOL.

[Aldo62 in reply to Ramp7]

My goal as well.

[MateoBeach]

Your trial of BAT is a sound one. One month high T then one month AR blockade. After two cycles (4 months) you should check nadir PSA (last week on Orgo/Nubeqa). Is it down, steady of rising? If rising discontinue BAT. If down it is working. BAT is not just to resensitize toADT. It is to suppress the cancer directly using supraphysiologic testosterone which many PC populations cannot handle. Alternating with AR blockade suppresses anothe population of cells. And keeps the cancer from evolving mutations what will always arise with any continuous treatment. But at personal trial such as you are doing is necessary to identify those who are favorable responders or not.

I have been on modified BAT (three months of of very high T from T-cypionate 250 meg every week, not 400/month, or pBAT with propionate which is even better; Alternating with one month on Orgovyx and Nubeqa. I am no at nearly 3 years on BAT and nadir PSAs remain undetectable. I do have leg, glute and some back pain but it is not from the BAT. Rather recovering from a very serious GBS infection that "ate" my lower body muscles last Spring. Recovery is slow but steady with lots of work.

Your T5 spine met may be a problem if stimulated rather than repressed by high testosterone. I suggest consulting your RO to see if it could be eliminated with SBRT. Good luck. MB

[PCaWarrior in reply to MateoBeach]

I agree with most of what you wrote. One small point though: a rising PSA does not mean that BAT is an unqualified failure. My nadir PSA has been rising but I monitor my PSADT and make sure it is over 2 years. By that metric I'm doing well.

SBRT seems prudent.

[GardenReno]

hi, I’m 60 years old stage 4 like you and doing BAT. No muscle pain at all. In fact feeling really good at present. I agree with other comments that you probably need a scan to check where the cancer is at. My PSA is currently 2.8 and will get a new PSMA scan in January. All the best cheers Ian

[Aldo62]

After a week, the inflammation feels like it is finally subsiding. Castor Oil pack seemed to help. Hopefully it will soon disappear and it won't hurt so much next time around!

[PCaWarrior]

Yes, some guys get muscle pain when starting BAT. It is usually from inflammatory factors and not from cancer. A friend of mine started BAT and had bad muscle pain. He feared the worst but it subsided.

Pain could be inflammation but it could also be from cancer.

Perhaps consult with Denmeade. He's the BAT expert.

[SViking]

after four months of BAT my PSA went from 12 to 98. Started the Nubeqa again yesterday. I still have a lot of lower back and hip pain. That’s most pronounced at night when trying to sleep.