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Yeah Ed agree with your information and knew that and understand that awhile ago, it can make its own fuel at some juncture without T levels happening. Xtandi(MDV3100) is an invention found to bind to the AR receptor when others like casodex, eulexin and nilandron have failed to be useful, the other drug Dr. Sawyers co-invented is ARN-509 it is like MDV3100 but might bind even better is the idea.
Zytiga as far as my simplistic boiled down thinking is re-engineered Ketoconazole and should hopefully work better than Keto, however Keto is dirt cheap in comparison, so for budget or cash buyers a huge consideration. What I really like seeing is combo drugs and cheap stuff that actually works or render results, we seldom see endorsements for the cheap drugs (estrogenics, keto, even casodex and some others). Whatever works for a patient is the main goal (regardless of pricing-in theory anyway), we want results and don't care about the details.
If you get chance read about the HedgeHog pathway (it is for real on cancers) and they are finding drugs that can render successes right now, they have not tried that much on combo drugs just yet and there might be some big future promise in doing such protocols. There are various pathways to effect PCa and that is why types of drugs out there are so darn similar. They have found we have estrogen receptors and it is even wilder than the AR receptor, it appears there is an alpha, a beta and maybe 3 other junk pathways for estrogens to effect PCa or our biologies....they cannot figure out how all of them interact and work, thus far. Seen some Journal article on such not long ago. We are for the most part given the dart board approach or playbook approach to patients for HT related therapies, they are not usualy custom tailored, at this time, but that is likely coming some day.
current thought tends to hold that LOW testosterone is one of the possible causes of PCa. I am on TRT, and Active Surveillance.
the linkage of testosterone to PCa is old school, and based upon flawed research and samplings.
it's an exhaustive topic, and I just don't have time now to write it all. do your own research. Abraham Morgentaler, M.D. was the one who broke it open in the mid 2000s, by actually going back and looking a the early studies, that were taken as gospel for 5 decades or more.
he found serious statistical, and modeling errors in the old research and thought. it's a real eye opener!!
I'll close with this bit of logic: if PCa was caused by high testosterone levels, why are there no cases from young men? where are the cases seen? IN OLDER men. what's going on in older men? LOWERED testosterone levels.
You can believe what you like but please don't encourage the users of this forum to think that if they let their testosterone rip their PCa will go away. That would be dangerous advice.
Young men don't get PCa (usually) because the cell reproduction system goes awry with age. Things go wrong in our bodies as we age and PCa is just one of those things that result. Our testosterone does decrease with age but remains a source of strength to the cancer.
If I were not on treatment suppressing my testosterone (successfully) and hence my DHT also, after nearly six years with a Gleason 9 PSA 62 at the outset, I'd be six feet under.
I can certainly live with the insignificant testosterone in my body. Perhaps a young man could not but, knocking 70, I'm very glad to be beating the PCa odds .
