Clinic
Questions that change the conversation.
Print this page or screenshot it. Bring scans and any genomic report.
Is this the right setting?
- Is my disease CRPC or still hormone-sensitive?
- If HSPC, is there a protocol (BATMAN-style or SPIDERMAN) or are we improvising?
- Do I have cord-threat, obstruction, or painful bone disease that made Hopkins trials exclude men?
- Is a BAT trial open instead of off-label use?
How would we give it?
- Will ADT stay on the entire time?
- Cypionate 400 mg IM every 28 days, or a different ester / schedule?
- Who injects, and what is the backup if I miss day 29?
- Are we adding darolutamide, enzalutamide, olaparib, radium, or LuPSMA on a published calendar?
How will we know it is working?
- What do we do with a PSA rise in the first two cycles?
- When is the first scan, and will we use PCWG3 flare rules?
- What is the stop rule that is not “PSA went up once”?
Safety in my body
- Hematocrit, blood pressure, sleep apnea, heart failure, prior MI?
- Who watches gynecomastia, edema, and the 48-hour pain flare?
- Drug coverage for off-label testosterone in prostate cancer?
Biology that might change the bet
- AR amplification or mutation in tissue or ctDNA?
- AR-V7?
- BRCA, ATM, CDK12, CHEK2, or other HRR alterations?
- PSMA PET burden?
The move after BAT
- If this is a resensitization play, which ARPI comes next?
- Are we planning STEP-UP-style switching rather than one BAT course?
- If I am Type 4 / NEPC, what is plan B?