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Cancer: Prostate Message Board

Cancer: Prostate Board Index

This newer “wave” of findings with regards to the intratumoral affairs of cancerous cells is revolutionizing the methods used in the hormonal treatment, and professionals will have to adjust and follow suit. After all, you have to feed the beast to keep him quiet.

In a past thread I have discussed with Jim about the importance of cells behaviour.

These human little parts are all prepared to adapt to newer environments to survive, and when threatened they will do what it is necessary even in activating their tinny androgen “factories” to produce their own food (intratumoral androgens).
The newer drugs have been conceived to address these activities and one should just hope that scientist lead their findings and purposes to success. The old ways in treatment may become obsolete.

It seems that Alpha Reductase Inhibitors in the hormonal context are important and not necessarily influencing the “behavioural adaption” of cancer cells, to consider any intratumoral production of androgens, even if one takes it continuously.
In any case, I have no doubts in the need of changing the traditional hormonal treatment to include the overall context of the treatment. Anecdotally speaking, I see the present setting like this;

Testes and Adrenal Glands produce androgens and cancer cells survive by feeding on androgens (mostly common referred as Testosterone and Dihydrotestosterone). HT therefore will try to “kill” or manage the cancer advancement by starving the cells cutting their feeding routes.

Using traditional HT drugs one can reach to castration levels of androgens (circulating in the body) of 95% with LHRH agonists. I say this just by comparing the testosterone proteins alone in their normal levels of 400 ng/dL against the castrate at 20 ng/dL.
The 5% in circulation is then considered the “culprit” of the problem for feeding the cancer which will allow it to survive.
Without any weapon (or possibility) to stop the “total production” of androgens (we need them for other system functions), specialists use tactics to prevent the androgens from being ingested by the cells, simply zipping their “mouths” (receptors), using the "sticky" antiandrogen drugs.

Still going further, they use 5-ARI drugs, to prevent “production” of dihydrotestosterone, which is considered tenfold more powerful than its sibling, the testosterone.
These tinny “super-calories” could provide the cells an extension in their surviving times ten “clocks” more than if they were fed on testosterone. This is a good reason why we should consider the drug in our protocols.

The overall is therefore what we know at present times as Total Blockade (or Total Androgen Deprivation Therapy), however that does not count with the intratumoral blockade.

In any case, the small percentage of androgens circulating in the body is being manufactured everyday and is consumed by the whole body, and by those cells that managed to unzip their “mouths” or strive through other means.

This situation is noticed when one has low levels of androgens in circulation but the cancer is active as expressed in a rising PSA. The case (patient) is then referred as Hormone Refractory Prostate Cancer (HRPC).
This is an ambiguous situation because it looks into refractory from the traditional hormonal drugs. It does not include the so called Intratumoral activities that have been taking place all along, probably in a dormant behaviour, which existence nobody knew.

The “antiandrogen withdrawal syndrome” is also a short lived phenomenon. At such times the intratumoral activity is taking the lead in the advancement of the disease with or without the ARI drugs.


Baptista ;)

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