2 Comments
Nov 14, 2023Liked by Keith R. Holden, M.D.

That was the most comprehensive and best explanation I have read to date about BAT. Consistent with your post, rather than characterize BAT as “paradoxical “, I would describe it as further evidence that continuing to “feed” the cancer cells with testosterone during the entire treatment protocol will lessen the risk, or extend the time, that the cells become castration resistant. I have used intermittent anti androgen therapy, plus metastasis directed therapy, to remain metastatic hormone sensitive for more than 15 years. By skipping the LHRH agonist or antagonist and using only ant- androgen mono therapy, testosterone rises during the on period, thereby feeding the cells with testosterone during the off period(“BAT Lite”). This lessens the need for the cells to mutate to find lower and lower levels of testosterone. The potential benefits of this protocol is described well by Dr. Gatenby at Moffitt Cancer Center in Tampa (the Darwinian or evolutionary approach to cancer treatment).

Expand full comment