darolutamide without Lupron?

[janebob99]

Has anyone tried darolutamide without doing Lupron? Seems like that would help to treat PCa without lowering T-levels. I realize that the standard protocol is doing Lupron first, followed by darolutamide second (if needed).

[Tall_Allen]

Testosterone is useless to you if it can't get into any of your cells. Anti-androgens block access to your cells. Lupron+Xtandi is more effective in fighting cancer than Xtandi (or Lupron) alone, probably the same is true for Nubeqa.

[janebob99 in reply to Tall_Allen]

Thanks for clarifying that. I wasn't sure how it worked. So, having high levels of testosterone is useless when an anti-androgen drug, like Xtandi or Nubeqa, blocks the activity of testosterone at the cellular level.

[dhccpa in reply to janebob99]

Yes, a fair number of posters seem to push the "mides" over AA because it doesn't block T directly. But may be a moot point.

[janebob99 in reply to dhccpa]

I agree. Thanks.

[dhccpa in reply to janebob99]

Meant to say the "mides." Darolutimide, enzalutamide, etc.

[janebob99 in reply to dhccpa]

I thought that might be the case. Thanks !

[maley2711]

Studies surely provide evidence of better outcomes with both...question is, how much better ? Same thought has crossed my mind.....have you Googled or pubmed? The answer might be different for combined ADT + RT than for metastatic systemic treatment.

[lokibear0803]

I recently asked my MO about this. No, darolutamide doesn’t lower T, but it does block uptake/use by androgen receptors. Addressing my concern around muscle loss, she stated that there are other receptors other than the androgen receptor that can use T … I didn’t press for details, since my takeaway was that the effect is likely minimal in terms of preserving muscle. That said, a quick search just now gave me this, which may or may not be a piece of what she was referring to:

en.wikipedia.org/wiki/Membr...

That said, my plan would be to use ADT (in my case, relugolix) with darolutamide and just keep on with the lifting to preserve muscle. As comedic writer Dave Barry has suggested, “Stay Fit and Healthy Until You’re Dead”.

amazon.com/Dave-Barrys-Heal...

[KocoPr]

Daro doesn’t cross the blood brain barrier so testosterone can still be utilized in the brain. To me that is important for my mental health.

You also need to consider all this T going down the aromatase pathway creating lots of estrogen. If I were to do what you say I would closely monitor my estrogens.

You can control the aromatase enzymes with inhibitors but again you need to constantly monitor your estrogens.

I do similar with intermittent orgovy and pBAT (propionate BAT). I only take Orgovyx with darolutamide during my low T cycles but stop both during high T cycles. I test E2,T, PSA about every other week and adjust Orgovyx by extending the days.

I am trying to keep my low T around 20ng/dl or lower. I am also trying to keep my E2 around 20pg/ml. Basically so far the E2, and T are seesawing depending on Orgovyx.

I know i know my wife always tells me enough already! Lol

[janebob99 in reply to KocoPr]

Thanks. That's a complicated regimen you have there. Sounds like it's working for you though. Are you trying to keep the estrogen down deliberately? If so, why?

From what I've read, transdermal estrogen patches or gels are effective at fighting many of the bad side effects of Lupron, etc.. I have 10 recent papers on the subject. If you'd like I can email them to you.

[KocoPr in reply to janebob99]

those parers would be great.

Im not trying to keep it down but struggling to keeit up around 20. To much and I believe the ratio of low T and high E is beneficial to the beast.

I try to tell anyone who complains about anger, depression etc after long term ADT need to check your estrogen levels.

My OC supports my non SOC BAT but I have to buy my own propionate and he didn’t want me taking transdermal estrogen because of possible heart complications. Now I know that is old school and refers to oral E but I didn’t want to correct him as we have a great repore and i can get E2 myself. So far I control E2 levels the way I explained above.