Active
The disease is moving, decisions made now shape everything that follows.
The disease is moving, and the decisions made now, about what to treat, how, and in what sequence, will shape everything that follows.
3 papers. Why they matter here.
- Paper 1
Tumour Ecology and Evolutionary Stability
Read the paper →Why aggressive disease arises from ecological collapse, and how treatment decisions affect the evolutionary trajectory that follows.
- Paper 2
Cancer as an Ecological and Evolutionary System
Read the paper →Adaptive therapy. Why managing the tumour ecosystem produces better evolutionary outcomes than attempting to eliminate it.
- Paper 3
PSA Kinetics and the Natural History of Prostate Cancer
Read the paper →PSA kinetics as the real-time window into biological momentum. Distinguishing genuine acceleration from noise.
13 papers. Why they matter here.
- Paper 1
The Three Layers of Intervention
Read the paper →The full depth model. Why active disease requires coordinated action across output, signalling, and structural layers simultaneously.
- Paper 2
Signal, Stress, and Selection
Read the paper →The sequencing architecture for active disease. How to apply pressure without accelerating the resistance it is trying to prevent.
- Paper 3
Dynamic Fitness Landscapes and Evolutionary Constraint in Prostate Cancer
Read the paper →Why continuous maximal pressure selects for resistance, and why oscillating treatment environments prevent tumour populations from reaching stable adaptive optima. The evolutionary rationale for sequencing.
- Paper 4
From Intervention to Environment
Read the paper →Why the sequence of interventions, not any individual agent, is the mechanism at this phase.
- Paper 5
Rapamycin, mTOR Oscillation, and the p53-MDM2 Axis
Read the paper →Maintaining quality-control rhythm under active disease conditions.
- Paper 6
MDM2 as Convergence Point
Read the paper →The convergence point argument in the context of active disease, what addressing the upstream metabolic environment still achieves.
- Paper 7
Doxycycline: Multi-Pillar Analysis
Read the paper →The four convergent mechanisms and their relevance to active disease management.
- Paper 8
Testosterone, p53, and the MDM2 System
Read the paper →Preserving AR dependence during active disease. The saturation model and its implications for treatment sequencing.
- Paper 9
Oestrogen's Role in Prostate Cancer
Read the paper →The four oestrogen mechanisms as active drivers of progressive disease, and what addressing them achieves.
- Paper 10
Sirtuins, NAD⁺, and the Quiet Biology Framework
Read the paper →The SIRT1 axis as a parallel control layer during active disease management.
- Paper 11
A Hierarchy of Biological Signals
Read the paper →Phase 4 spans Levels 3 and 4, functional shift and phenotype expression. The monitoring objective shifts to detecting PSA-biology decoupling before it becomes a signal failure.
- Paper 12
B7-H3 as an Adaptive Surface Phenotype
Read the paper →B7-H3 as a state marker of the immunosuppressive environment that active disease and ADT produce. Why upstream NF-κB and p53 intervention may slow the establishment of immune evasion — and how direct B7-H3 targeting fits alongside constraint management.
- Paper 13
Exercise as Medicine
Read the paper →Exercise under ADT and ARPI as a primary biological intervention, not supportive care. Three mechanistic legs — AMPK/mTOR metabolic signalling, mitochondrial quality control, and stromal remodelling via the CNTF axis — each independently justify the prescription. Muscle preservation, fatigue reduction, cardiovascular protection, and bone density maintenance are mechanistically grounded and clinically supported for the hormonal suppression context of this phase.