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.
Non-Metastatic Prostate Cancer
Shorter prostate-specific antigen doubling time was significantly associated with shorter metastasis-free survival and overall survival.
The development of metastasis was associated with a 3-fold higher risk of death.
The onset of non-metastatic castrate-resistant prostate cancer and metastatic castrate-resistant prostate cancer was associated with substantial cost increases.
Prostate cancer treatments, particularly hormone therapy (ADT) can have a significant effect on speeding up the process of thinning and weakening the bones. There are some available treatments (Zoledronic acid aka Zoladex and denosumab aka Xgeva) which are designed to slow down or reverse this process; however, they are known to have many adverse side effects themselves. These side effects can include severe fractures of the femur which could limit survival and cataracts. For this reason, these treatments are usually used later, when men become castrate resistant and metastatic.
Two game changing trials demonstrated that the early use of Zytiga along with hormone therapy (ADT) can provide a significant survival advantage for men with aggressive, hormone naive prostate cancer. The data is very clear for men with metastatic disease, but there remains some controversy if this holds up for men who are not metastatic.
