Use Testosterone as a drug or Bipolar Androgen Therapy

kejongliu

Has anyone experienced this?  Although there are not many reports, I do find it quite interesting.  Basically, if things go sideway, there is nothing to lose, right.

More promising results and experiences by a medical doctor in the below YouTube video and an online publication. With BAT in every 6-8 week cycle, patients have good PSA and long-term outlook results. 

 

https://www.hopkinsmedicine.org/news/articles/testosterone-as-a-drug

Testosterone Therapy in Men with Advanced Prostate Cancer

 

I posted my illness in the forum thread below. Thank you.

https://csn.cancer.org/node/322675

VascodaGama

It may work in ADT refractory patients but with reservations

Kevin, 

There are many uncertainties on this bipolar androgen therapy. It is know that the cancer uses endogenous testosterone not the exogenous one used by these researchers. In fact it is known that exogenous testosterone lowers the fabrication (by the testis) of endogenous testosterone which indirectly will lower cancer activity (represented by lower or stable PSA). This is what ADT drugs do in individuals with responsive cancer non refractory. However not all PCa cells produce PSA and those more aggressive rate 4 and 5 may not produce PSA at all. The researchers of your link used the PSA marker to identify success with a very low percentage in outcomes. 

Bipolar androgen therapy will also become refractory when cancer sees no androgens. ADT administered intermittently seems to be a better choice as its goal is to trick the bandit in a way that fakes the supply of androgens at controlled occasions  so that the bandit will not try fabricating androgens by itself.  It is like "now you have it, now you don't ".

In your case the bandit is responding to ADT. You only need to avoid refractory limiting the time on drugs. 

Best

VG

kejongliu

VascodaGama said:

It may work in ADT refractory patients but with reservations

Kevin, 

There are many uncertainties on this bipolar androgen therapy. It is know that the cancer uses endogenous testosterone not the exogenous one used by these researchers. In fact it is known that exogenous testosterone lowers the fabrication (by the testis) of endogenous testosterone which indirectly will lower cancer activity (represented by lower or stable PSA). This is what ADT drugs do in individuals with responsive cancer non refractory. However not all PCa cells produce PSA and those more aggressive rate 4 and 5 may not produce PSA at all. The researchers of your link used the PSA marker to identify success with a very low percentage in outcomes. 

Bipolar androgen therapy will also become refractory when cancer sees no androgens. ADT administered intermittently seems to be a better choice as its goal is to trick the bandit in a way that fakes the supply of androgens at controlled occasions  so that the bandit will not try fabricating androgens by itself.  It is like "now you have it, now you don't ".

In your case the bandit is responding to ADT. You only need to avoid refractory limiting the time on drugs. 

Best

VG

Thank you, VG.  The pathology

Thank you, VG.  The pathology report says 4+5, but my PSA level tends up very quickly after RP.  5 out of 14 lymph nodes were positive.  This would indicate multiple lesions but both the bone scan and Ga-68 scan could not find any. Most likely another two false negatives.  

If indeed my illness becomes castrate-resistant, then the 2nd line of anti-receptor drugs such Abiraterone acetate (Zytiga) may only work for a short period of time.  Plus, I am going to get hit hard with those side effects.  Regarding this skeptical BAT, I wonder what can go wrong or what would I lose if things go sideways?  Depo-T for sure will enhance my quality of life and if it doesn't fuel the bandit, so the pros outweigh the cons, right?  

VascodaGama

TRT

In this forum there have been guys inquiring on the matter before but no one ever reported on experiences with conclusive results. I  never tried enhanced drugs and do not know if they would help in diminishing the effects of hypogonadism and improve symptoms. A member of this forum involved in bodybuilding with PCa reported taking steroids for his competitions. He stopped participating in the forum and we never got information on the influence it caused to his PCa.

 There is much controversy about the idea that TRT will awaken the cancer or even turn it more active. Most medical associations do not recommend the practice in PCa patients and it will be hard to find a doctor that would deviate from the guidelines of their association. The practice at JH your link seems to be directed to crpc patients. Your case is not crpc but you can try contacting them to access possibilities in having it. In the end it is your body and you should care about it in your terms. However do not let those clinical papers to influence your decision because they do not address many of the issues that should assure a conclusive success. The PSA is not a feasible variable to access conclusions. The testosterone count and FSH should be in play too. The type of cancerous cells also influence the judgment as many among the billions in a tumour produce lesser antigens, and while some die at their proper timing, some others are prevented from dying. Nobody knows which ones are more prune to refractory due to the lack of androgens or more resistant to chemo and/or radiation blows thrown to them. PCa makes part of our complex building blocks.

ADT has many cases of experience since the 1990th and the results are easily understood. The intermittent modality started by chance by a fewer number of medical oncologists in the same principle as that of those reachers of your link. They applied the methodology, followed the results and draw conclusions, however,  in ADT they had tools to revert the situation (antiandrogens and agonists). In CRPC cases such would be impossible. 

I am confronting a systemic case but I am not crpc. I still can control the bandit with intermittent ADT. If interested in the details look for my previous threads.

Best,

VG

Clevelandguy

Go for it

Hi,

I am about 7 yrs. past Prostate surgery with undectable PSA but would not risk my future taking any type of testosterone enhancement medications.  We all lose muscle mass and strength as we age but a Pca cancer patient using testosterone drugs, not enough data, not enough trials on what the outcome would be.  In my humble non medical opinion by taking testosterone enhancement drugs one of two outcomes will happen, the cancer will increase or it might not.  My goal through surgery was to remove the cancer. You will not find me feeding my body with drugs to see if it increases or stays the same, that I will leave up to you.

Dave 3+4

kejongliu

One more video to share

Bipolar androgen therapy - John T. Isaacs

https://www.youtube.com/watch?v=HngwumpKR68

I cannot find a urologist or an oncologist to prescribe me Depo-testostrone for 8-week and then 5-week blockers.  Will try to reach to this presenter of the video and see.  

Great thank VG and inputs from Clevelandguy.  Much appreciate your info. 

 

kejongliu

Some Q/A by Samuel

Not sure if this is the same guy, Samuel, referred by the video presenter.  you can also download a pdf from the webpage.

https://www.hematologyandoncology.net/archives/june-2018/bipolar-androgen-therapy-in-the-treatment-of-prostate-cancer/

VascodaGama

Curiosity killed the cat

Kevin,

Thanks for the links. And yes, the researches done by the medical oncologist Samuel are presented by his laboratory colleague Dr. Isaacs (biomolecular engineering researcher) in his presentation in the video.

This thread recalls the medical wars between medical oncologists and urologists in the 1990th. More precisely between Myers (oncologist) and Walsh (urologist) that would not accept the principles in treating PCa with drugs instead of dissecting. Patrick Walsh was at the time veneered as the best doctor treating prostate cancer which fact led to classify Johns Hopkins as the number one hospital in the world for PCa matters. Surely the AUA was backing up his member when urological surgery had the title of the Golden Standard of PCa Treatment.

Several medical oncologists involved in PCa researches had evidence on the use of drugs and methodology in treating PCa but the Urological Associations would not accept their findings. The war continues today and even Isaacs (now a top notch at JH) comments on the matter at some times in the video. In fact, it didn’t surprised me for being him to do the presentation of Samuel’s researches. 

Similarly to this bipolar androgen therapy initiative, the intermittent ADT also arised from the tricks and reactions on the cells androgen receptors (AR). Soon they found that by controlling the effects on AR they could extend the status of the cancer for long periods of time (15 or more years). The intermittent modality comes from real experiences in stopping the drugs to alleviate the symptoms caused by the drugs. The timing for stopping (off) and restarting (on) ADT varies from doctor to doctor and the drugs involved depend much on the patient condition. The BPT is not a crazy treatment as many may think. It has also its logics based on facts from several researches (since the 1990th) but fewer clinical trials. I read the Isaacs papers/findings on the dihydrotestosterone metabolism whose control makes part in ADT principles. Dihydrotestosterone is a powerful androgen made from testosterone and much wanted by the bandit. The newer popular drugs Xtandi and Zytiga pretend to avoid such metabolism from happening. Before these drugs existing oncologists used 5-alpha reductase inhibitors (Avodart or Finasteride) which would be working in a triple ADT  blockade. ketoconazole (a sort of fungus medicine used in shampoos) was also incorporated to avoid intra metabolism in cells, all attempting the control of cell’s AR behavior. 

Samuel researches involve those aspects. They got credible results but still in a fewer number. The published trial results involve CRPC patients which may not be what the PCa community wants. I am not against BPT but I  do not have hypogonadism symptoms or fatigue requiring steroids. As I said before, you may try it if interested. At least you know that your cancer seam to respond to ADT. 

Though ADT has never been recommended as a solo treatment for PCa, I know of some guys that used it intermittently and in combinations as their primer along 20 years. Curious people manage to find the facts in a much shorter time than the one taken in clinical trials or FDA approved. 

Best,

VG

 

 

artie

VascodaGama said:

Curiosity killed the cat

Kevin,

Thanks for the links. And yes, the researches done by the medical oncologist Samuel are presented by his laboratory colleague Dr. Isaacs (biomolecular engineering researcher) in his presentation in the video.

This thread recalls the medical wars between medical oncologists and urologists in the 1990th. More precisely between Myers (oncologist) and Walsh (urologist) that would not accept the principles in treating PCa with drugs instead of dissecting. Patrick Walsh was at the time veneered as the best doctor treating prostate cancer which fact led to classify Johns Hopkins as the number one hospital in the world for PCa matters. Surely the AUA was backing up his member when urological surgery had the title of the Golden Standard of PCa Treatment.

Several medical oncologists involved in PCa researches had evidence on the use of drugs and methodology in treating PCa but the Urological Associations would not accept their findings. The war continues today and even Isaacs (now a top notch at JH) comments on the matter at some times in the video. In fact, it didn’t surprised me for being him to do the presentation of Samuel’s researches. 

Similarly to this bipolar androgen therapy initiative, the intermittent ADT also arised from the tricks and reactions on the cells androgen receptors (AR). Soon they found that by controlling the effects on AR they could extend the status of the cancer for long periods of time (15 or more years). The intermittent modality comes from real experiences in stopping the drugs to alleviate the symptoms caused by the drugs. The timing for stopping (off) and restarting (on) ADT varies from doctor to doctor and the drugs involved depend much on the patient condition. The BPT is not a crazy treatment as many may think. It has also its logics based on facts from several researches (since the 1990th) but fewer clinical trials. I read the Isaacs papers/findings on the dihydrotestosterone metabolism whose control makes part in ADT principles. Dihydrotestosterone is a powerful androgen made from testosterone and much wanted by the bandit. The newer popular drugs Xtandi and Zytiga pretend to avoid such metabolism from happening. Before these drugs existing oncologists used 5-alpha reductase inhibitors (Avodart or Finasteride) which would be working in a triple ADT  blockade. ketoconazole (a sort of fungus medicine used in shampoos) was also incorporated to avoid intra metabolism in cells, all attempting the control of cell’s AR behavior. 

Samuel researches involve those aspects. They got credible results but still in a fewer number. The published trial results involve CRPC patients which may not be what the PCa community wants. I am not against BPT but I  do not have hypogonadism symptoms or fatigue requiring steroids. As I said before, you may try it if interested. At least you know that your cancer seam to respond to ADT. 

Though ADT has never been recommended as a solo treatment for PCa, I know of some guys that used it intermittently and in combinations as their primer along 20 years. Curious people manage to find the facts in a much shorter time than the one taken in clinical trials or FDA approved. 

Best,

VG

 

 

low testosterone

I had PC gleasn 7 and was treated with degaralix,firmagon, had 5 treatments targeted radiation at Sloan in 2015.Cancer gone PSA nondetecable, but left with low testosterone,24, top Prostate cancer DR at Sloan says ok to get TRT but so far all drs will not give me trt because of my  pc history.Gaiing weight,have belly now, but otherwise ok.Based on my review of your posts u seem to b knowledgable and would like your suggestions.Live in Boca Raton Fl 8 months and Huntington NY 4mos.

Old Salt

Question

Why can't the Sloan-Kettering doc help you with a prescription?

Whatever, stay active and exercise as much as possible to minimize weight gain etc.

kejongliu

artie said:

low testosterone

I had PC gleasn 7 and was treated with degaralix,firmagon, had 5 treatments targeted radiation at Sloan in 2015.Cancer gone PSA nondetecable, but left with low testosterone,24, top Prostate cancer DR at Sloan says ok to get TRT but so far all drs will not give me trt because of my  pc history.Gaiing weight,have belly now, but otherwise ok.Based on my review of your posts u seem to b knowledgable and would like your suggestions.Live in Boca Raton Fl 8 months and Huntington NY 4mos.

Why no TRT

"top Prostate cancer DR at Sloan says ok to get TRT"  Then I wonder why he or she couldn't prescribe this.  From what I have read so far, TRT cycle can be done in:

High T for a period of eight weeks then androgen blocker (enzalutamide) for four weeks.  400 mg per intramuscular (IM) injection; every two to four weeks to a target level of T at 60 nmole/L or 1730 ng/ml.  Most concentrated generic T comes in depo-T 200 mg/mL.