BAT: A Patient's Guide

https://onlinelibrary.wiley.com/doi/full/10.1002/pros.24328

I don't think this paper has been posted before. The author, Denmeade, seems to be the godfather of Bipolar Androgen Therapy. Over the past decade his group seems to be really getting things sorted out with BAT. Hopefully, it won't be long before FDA approval comes. As he points out, BAT isn't appropriate for all CRPCa patients and it doesn't work for all patients, but it still holds a lot of hope for plenty of folks. The article is long and probably answers any questions about BAT a person could have. What I found very encouraging is that BAT can resensitivze a prolonged response to 2nd gen antiandrogens, and maybe give some relief from the effects of ADT. Because BAT kills some PCa cells outright and "reprograms" other PCa cells for death by ADT, it seems like the therapy could be repeated. I didn't see the author's thoughts on repeated use but I didn't thoroughly examine the paper (Lupron brain = short attention span). Oh, and BAT is cheap -- $50 plus the cost of having a nurse inject it every 28 days.

3 CONCLUSIONS
The key findings from these clinical studies are that BAT (a) can be safely administered to asymptomatic patients with metastatic CRPC; (b) does not produce symptomatic disease progression; (c) produces sustained PSA and objective responses in 30-40% of patients and (d) can resensitize and prolong response to subsequent antiandrogen therapy. Patients need to remember that BAT is not FDA-approved therapy, does not work for everyone, and is not without risk. It is important for physicians not to overpromise results from BAT on quality of life and sexual function.

I began talking to my docs- who currently have me on Ereleada And Orgovix for about 2 years now- about BAT near the beginning of being put on these drugs.

EDIT: long post edited by me after I read all of the long article linked to in the OP and realized that I had misunderstood what BAT was. Since BAT is only adding something ( I think ) to ADT therapy, then the expense ( incoming revenue ) of ADT should be irrelevant to the adoption of BAT. Other things might influence it's widespread adoption, but not the staggering expense of Erleada/Orgovix/Xgeva.

I pray that BAT is soon proven to be effective and widely adopted. Not only because of the improvement in results from treatment, but because thank it would wipe out greatly decrease the onerous side effects of removing testosterone from a man at least for two or three weeks per month. Though it would be probably unpleasant during the week or so when testosterone levels are again allowed to plunge two castrate levels, I suspect that the previous two or three weeks of very high testosterone levels would be wonderful. Resulting in an increase in strength and energy and maybe even resistance to disease. Perhaps an increase in immune function, and a reduction in triglycerides and blood sugar and fasting blood insulin. Probably an increase in muscle mass along with a decrease in fat mass. So I hope it works and gets adopted into widespread use.

Post Edited (BillyBob@388) : 10/12/2023 5:34:13 AM (GMT-8)

My concerns about loss of revenue interfering with acceptance of BAT are(probably) incorrect. As I read further into the long article, I realized that BAT is the usual ADT drugs PLUS large doses of testosterone. So, the ADT revenue can continue.

The next thing the article made more clear for me is that this would not be available for anyone until ADT had failed and we are castrate resistant. But you continue on with the chemical castration even though it is not helping with the cancer anymore, and just add the large amounts of testosterone once a month. So that we cycle back and forth, over a 28 day period, from super high testosterone levels to <50 castrate levels and back up again, over and over. These are 2 things I did not understand about BAT therapy.