ADT and increased mortality

[Ed Friedman]

The following article shows that ADT increases mortality due to heart
attacks and strokes.
See: https://www.tandfonline.com/doi/full/10.1080/13685538.2022.2091130

[cbcppml]

But does not resorting to ADT perhaps cause a higher mortality rate than what is caused by not employing it?

[LeeLiam]

Ed,

What are your thoughts on this matter when using BAT? Also, when using estrogen?

[Ed Friedman]

In my opinion BAT should always use an aromatase inhibitor because
estradiol leads to increased levels of ER-alpha which in turn leads to
CRPC. See:
https://www.researchgate.net/publication/362276475_The_Strengths_and_Weaknesses_of_Bipolar_Androgen_Therapy

In terms of overall mortality, the best numbers are currently being
obtained by patients going to Dr. Leibowitz's practice
(compassionateoncology.org). Those patients typically are given high
dose T with 5AR inhibitors. Even for them, adding an aromatase inhibitor
should improve results.

Ed

[I.P. Freely]

Ed, have you convinced Dr. Leobowitz of this yet? He was against using
aromatase inhibitors when he was using his high T protocol with me a
couple of years ago.

Could that explain my repeat biochemical failure after a year or two on
high T? Could it reverse COMG's conclusion that I'm no longer a
candidate for repeat high T if and when my remission "expires"? I would
LOVE to go back on high T for many reasons including reversal of my
dramatic sarcopenia, better recovery from my very recent hip
replacement, improved mental clarity, energy recovery, and simply
feeling younger. Dr. Leibowitz's's partner, Dr Eshaghian, is convinced
that resuming high T is not medically feasible for me, especially while
I'm in remission. (My PSA is creeping up, but so slowly -- it's still
undetectable except by ultrasensitive testing -- that we don't want to
rock that boat.)

I.P.