Below is part of an interview posted on a prostate cancer web site. ADT (Androgen Deprivation Therapy) is medical speak for castration, whether chemical or surgical, when used to treat advanced prostate cancer. Well over a half million men in North America are on ADT at this time.

Could men on ADT be protected from COVID-19?

Prostatepedia

27 March 2020

Dr. Oliver Sartor, one of the leading researchers in advanced prostate cancer today, talks about what is happening in New Orleans this week and a potential link between COVID-19 and prostate cancer.

He is the Laborde Professor of Cancer Research in the Medicine and Urology Departments of the Tulane School of Medicine, the editor-in-chief of Clinical Genitourinary Cancer and the author of more than 400 scientific papers.

Prostatepedia asks: Is there a possible link between prostate cancer and COVID-19?

One of the receptors that the virus binds to is TMPRSS2. TMPRSS2 is well known in prostate cancer circles because it is expressed in prostate cancer and is part of a translocation, the TMPRSS2-ERG translocation, or TMPRSS2-S family translocation, which occurs in about half of men. TMPRSS2 is also expressed in the lung. You may have read that there is a predilection toward male death in this disease. The infection rate doesn't seem to vary particularly, although men may have a slightly higher infection rate, but the death rate and severe COVID-19 disease rate is worse in men.

TMPRSS2 in the lung can be downregulated, or reduced or suppressed, by androgen deprivation therapy (ADT). Alexander Meisel, from the University Hospital in Zurich, brought this idea to Bayer, who has a drug called Nubeqa (darolutamide). This drug can downregulate the androgen receptor and is reversible. Bayer is going to do a clinical trial in hospitalized COVID-19 patients using Nubeqa (darolutamide)

There are other agents that could be used in this setting. Some may be as simple as Casodex (bicalutamide). This is not an endorsement for people to start taking Casodex (bicalutamide), but a clinical trial will be done on ADT. Because the TMPRSS2 is a receptor for the virus and is expressed within lung tissue, that may explain part of the male predilection for severe COVID-19 illness.

[Prostatepedia’s Note: This means that there is a chance that men on Androgen Deprivation Therapy are protected slightly from COVID-19 compared to men their age not on ADT. Clinical Trials are underway; please do not rush to ask your doctor to prescribe ADT unless you are already in treatment. This is just a hypothesis and has not been shown to be true.]

Do you have any advice for men with prostate cancer this week in terms of the COVID-19 pandemic?

ADT and the variety of hormonal therapies we use, including Zytiga (abiraterone), Xtandi (enzalutamide), and Nubeqa (darolutamide), are not immunosuppressive. People on those types of agents are not particularly susceptible to the virus. Based on this new hypothesis, they could even have some protection, which of course remains to be proven. It's just a hypothesis, and it may not be true. I don't want to go overboard by promising people with ADT that they're less susceptible.

https://www.prostatepedia.net/blogs/pro ... ate-cancer (https://www.prostatepedia.net/blogs/pro ... ate-cancer)?

Can you imagine being in the recovery room at the hospital after becoming two stones lighter to reduce your chances of getting COVID-19 and hearing they just found the cure?

That would be like the millions of men with vasectomies who were later told that they now need to wear condoms during all sex acts to prevent endless new STDs and antibiotic resistant old STDs.

Imagine being ordered to line up at your local Walmart parking lot to get castrated in the Army medic tent, with thousands of other men, before you can have your job back.

cutnbulls2ox (imported) wrote: Tue Mar 31, 2020 10:30 am That would be like the millions of men with vasectomies who were later told that they now need to wear condoms during all sex acts to prevent endless new STDs and antibiotic resistant old STDs.

https://www.youtube.com/watch?v=2H0hAFtsHR0

CNN's Robyn Curnow interviews two scientists behind a study testing whether symptoms in male Covid-19 patients, who seem to be at a higher risk from the virus, can be reduced by treating them with estrogen.

Scientists trial female sex hormone for Covid-19 patients (

fhunter wrote: Tue Mar 31, 2020 12:54 pm https://www.youtube.com/watch?v=

YvJQylahEoI)

AnneK_TG (imported) wrote: Wed Apr 29, 2020 7:49 am Scientists trial female sex hormone for Covid-19 patients (

fhunter wrote: Tue Mar 31, 2020 12:54 pm https://www.youtube.com/watch?v=

YvJQylahEoI)

There is also a clinical trial just getting underway testing chemical castration as treatment for Covid-19. I'll post more information as it becomes available.

From what I had read a couple of weeks ago, it is women with their XX chromosomes that make them naturally better equipped to fight infections then men. Either the New York Times or Washington Post had stories about it. Possibly both.

Wolf-Pup (imported) wrote: Wed Apr 29, 2020 1:46 pm From what I had read a couple of weeks ago, it is women with their XX chromosomes that make them naturally better equipped to fight infections then men.

There are, of course, a number of different tactics being explored to confront Covid-19. As noted, women have two X-chromosomes and men have only one. In most women, one of their X-chromosomes is inactive. However, in some women the gene on the X-chromosome that produces the TLR7 protein is active on both, thus producing more TLR7. This protein, which detects single-stranded RNA viruses, such as coronaviruses, can help cells to detect and destroy the virus.

A second strand being explored is that both estrogen and progesterone boost immune functions in the body.

A third strand is that testosterone has both immune suppressive effects and inflammation enhancing effects. Reducing (or eliminating) testosterone would reverse these. This third strand is being investigated with both a New York-based study of the effects of chemical castration and two separate studies (London & Canada) on prostate cancer patients who are already on chemical castration. (I think the news media would shy away from suggesting any form of castration as treatment!)

A fourth possibility is that men just have worse habits than women. They smoke more and do less hand washing, among other things.

The answer, of course, doesn’t need to be just one of these. It might be some combination of all four.