I recently viewed two lectures by an Integrative Oncologist, Dawn Lemanne. I met Dawn several years ago when we both gave talks at a medical conference. Dawn’s training is in traditional oncology but also integrative medicine. In the following 2 talks, Dawn describes an ecological and evolutionary approach to incurable cancer treatment.

Preview YouTube video Dr. Dawn Lemanne – ‘Harnessing Evolution to Treat Cancer’Preview YouTube video Dr. Dawn Lemanne – ‘Harnessing Evolution to Treat Cancer’

Preview YouTube video Body of Wonder: Integrative Oncology: Transforming Cancer Management with Dawn Lemanne, MD, MPHPreview YouTube video Body of Wonder: Integrative Oncology: Transforming Cancer Management with Dawn Lemanne, MD, MPH

Below is a description of Intermittent Androgen Deprivation Therapy for metastatic prostate cancer. The idea is to intermittently treat with lower doses so as not to select out the resistant cells and allow the treatment sensitive cancer cells to compete with the resistant cells thereby prolonging life while minimizing treatment side-effects.

Important caveat- this is for incurable cancer, not applicable for the 60% of cancers that are curable. If one has a curable cancer this approach should not be taken. This distinction is critical.

Disclosure: the following is AI generated.

Key Concepts

• Intermittent Androgen Deprivation (IADT): Instead of continuous suppression, hormone therapy is administered in cycles. Treatment is applied until Serum Prostate-Specific Antigen (PSA) drops to a target threshold, after which therapy is suspended (the “off-treatment” phase). When PSA rises above a predefined ceiling, therapy resumes.
• Biological Rationale: Pausing therapy gives normal tissue and hormone production time to recover, temporarily reversing side effects like hot flashes, fatigue, metabolic dysfunction, and erectile loss. Biologically, cycling androgen exposure aims to prevent or delay the selective survival and expansion of androgen-independent (resistant) cancer cell clones.
• Bipolar Androgen Therapy (BAT): A more recent “pulsed” approach involving acute high-dose testosterone surges (“pulses”) followed by rapid drops back to castrate levels. This rapid oscillation exploits the adaptive mechanism of prostate cancer cells, inducing DNA damage and cellular senescence in tumors adapted to low-androgen environments.

Clinical Literature Findings

1. Non-Metastatic & Biochemical Recurrence: Phase III clinical trials have demonstrated that IADT provides equivalent overall survival to continuous ADT while yielding measurable improvements in quality of life and sexual health during off-treatment periods (Sciarra et al., 2013).
2. Metastatic Hormone-Sensitive Disease: Major cooperative trials (such as SWOG 9346) indicated that while IADT improves short-term quality of life, it may slightly compromise overall survival compared to continuous ADT in patients with high-burden metastatic disease (Sciarra et al., 2013).
3. Pulsed Testosterone / BAT Strategies: Preclinical and early-phase clinical studies show that pulsing testosterone levels can cause growth arrest in androgen-sensitive cells by down-regulating androgen receptor signaling and triggering cell cycle arrest (Gravina et al., 2017).

References

Gravina, G. L., Marampon, F., Sanità, P., Festuccia, C., Forcella, C., Scarsella, L., et al. (2017). Episode-like pulse testosterone supplementation induces tumor senescence and growth arrest down-modulating androgen receptor through modulation of p-ERK1/2, pARser81 and CDK1 signaling: biological implications for men treated with testosterone replacement therapy. Oncotarget, 8(69), 113792–113806. https://doi.org/10.18632/oncotarget.22776 Cited by: 13

Rashid, M. H., & Chaudhary, U. B. (2004). Intermittent androgen deprivation therapy for prostate cancer. The Oncologist, 9(3), 295–301. https://doi.org/10.1634/theoncologist.9-3-295 Cited by: 95

Sciarra, A., Abrahamsson, P. A., Brausi, M., Galsky, M., Mottet, N., Sartor, O., Tammela, T. L. J., & Calais da Silva, F. (2013). Intermittent androgen-deprivation therapy in prostate cancer: A critical review focused on phase 3 trials. European Urology, 64(5), 722–730. https://doi.org/10.1016/j.eururo.2013.04.020 Cited by: 75

Disclaimer: This post and this website are for educational purposes only and are not meant to be medical advice. Consult your physician for medical advice.

Eat clean, get morning sunlight exposure outdoors soon after awakening, follow good sleep habits, exercise wisely and regularly, rest often, enjoy the company of loved ones, spend time outdoors and live in the present.

Bob Hansen MD