This complete guide to Bipolar Androgen Therapy (BAT) should be your stepping-off point if you are interested in using BAT to treat your castrate-resistant prostate cancer (CrPC).
Several men have asked us if they are better off having 177Lu-PSMA-617 (Pluvicto) or Xofigo, a radiopharmaceutical drug that treats bone metastases. There is no simple answer, and the answer is not the same for each of us. Making a sound decision can be helped by understanding the mode of action and the limits of each treatment.
LYNPARZA (olaparib) and RUBRACA (rucaparib) are PARP Inhibitors that were FDA approved in May of 2020 for men with castrate resistant prostate cancer who also have certain genetic mutations. The FDA also approved certain Companion Diagnostic genetic tests to go along with the decision making to use these PARP Inhibitors.
There is a lot of information now available with these recent developments which makes decision making confusing.
There are several possible side effects that can result from receiving radiation treatment. The most common of these side effects include the development of scar tissue that makes it hard to urinate (pee), defecate (poop), and in some instances, link the activity of either peeing and pooping together; bladder or colon bleeding and diarrhea.
Myovant Sciences has developed an alternative gonadotropin-releasing hormone (GnRH) antagonist named relugolix. Their still investigational treatment is an oral (taken by mouth) as opposed to an injectable gonadotropin-releasing hormone (GnRH) antagonist. It has completed a very successful phase III clinical trial called HERO has been submitted to the FDA for approval. We at Cancer ABCs believe relugolix will be approved by the FDA shortly.
We know that the incidence of both cardiovascular disease (CVD) and prostate cancer increase with age, resulting in higher mortality. CVD is the second most common cause of death in men with prostate cancer [1,2] Hormone therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists like Lupron for treatment of prostate cancer has been linked to additional increases in CVD morbidity and mortality. This link is especially evident in the first year of treatment [3], and men with a history of CVD are at higher risk [3].
Degarelix, which is different from the (GnRH) agonists, is a GnRH receptor antagonist also approved for the treatment of men with advanced prostate cancer. However, good data is suggesting that degarelix might have a lower incidence of causing CVD than the GnRH agonists
One of the questions that often come up is how long a man should use an antiandrogen drug like Casodex along with a GnRH agonist like Lupron or Zoladex? There is no question that an antiandrogen needs to be used before the first dosage of the agonist (Lupron), but should the antiandrogen be stopped or should it be continued along with the agonist (combining an antiandrogen along with the GnRH agonist is often referred to as a combined androgen blockade)?
