Androgen Deprivation Therapy has quite a few serious side effects and complications. Lupron is often the first drug of choice and it has any number of side effects and complications that add to those already caused by Androgen Deprivation. Clots are one of the more serious of these complications. Appropriate and timely refferal must be made to a Physician specialized in managing Cardio Thoracic complications if an embolism has formed and "Yes" cancer growth must still be suppressed using some form of Androgen Deprivation Therapy.
If Lupron is no longer working there are a variety of other drugs available that need to be tried. A serious discussion with your Physician, usually a Urologist but sometimes an Oncologist, specialized in PCa reviewing the case in question should be obtained. It might also help to discuss the case with a Medical Social Worker who can counsel you and provide more insights than time allows your attending physician. Remember that a wholistic approach including diet and excercise is of great benefit to the patient.
Roughly speaking a PCa patient who starts with a Prostatectomy or ADT can have Radiation Treatment afterwards if both have failed and then reinitiate Androgen Deprivation Therapy with a new ADT drug that may be more effective. After ADT has been initiated Docetaxel, a combination of which is reported to extend life expectancy by up to about 27%, may be added depending on the case. Many naturopathic formulations are also known to extend survival especially when combined with the common therapies. Furthermore there are Vacines, which offer extended survival if effective, and then lastly Targeted Gene Therapy which is still under investigation as a Treatment with Curative Intent and only available in Clinical Trials.
Is Harley on warfarin? If so, I see no reason not to return to Lupron. I have experienced two episodes four years apart of double pulmonary embolism to both lungs and I continued Lupron through both. Following the first I was on warfarin. Two years later I experienced a rupture as a result of diverticulosis with severe rectal bleeding and following bringing that under control the hospital physician offered the installation of a filter in the vein that supposedly would stop future blood clots travelling to the lungs wherein I wouldn't require warfarin. Well, two years after that I experienced the second double whammy (so much for the "filter!") so returned to warfarin and have been on ever since whie also on Lupron. If Harley is on warfarin I do not personally see Lupron as causing any problem.
It's not that Lupron stops working in CRPC, but rather that an alternative source of androgen has been developed by the cancer. All sources need to be shut down for ADT to work. Thus, Lupron should be continued.
The medical profession has an appalling approach to dysfunctional coagulation. If one survives the trip to the ER, one is probably then on warfarin. But warfarin accounts for a large percentage of ER visits by older guys. & warfarin-related mortality is significant. Which is why it is not given as a prophylactic.
If one turns up at the ER with chest pain, a D-dimer test will be ordered. A zero reading means that there is no clot in the body. Elevated D-dimer is not conclusive for a clot, & so a chest scan will be done. If the lungs are clear, the D-dimer result will be ignored. You might have a DVT in a leg, but you came in with chest pain, not leg pain!
Since nattokinase is known to dissolve the fibrin that makes up a clot, we can order a D-dimer test from LEF (it's on sale) to assess the situation. If it is zero (or the lowest reading that the lab returns), we can rule out a clot. Otherwise, prudence suggests that nattokinase be used & D-dimer monitored.
A doctor will not treat solely on the basis of elevated D-dimer, but it's worth discussing the result with him/her. There might be another reason for the reading. However, in our demographic, an active clot or microclots is the likely cause.
I am not sure if this is relevant to your situation. I will be having my 4th Lupron shot 7/15/2016. I was discussing Lupron with my VA Urologist (who is on rotation from Duke University Medical Center). My psa is still non detectable as of April 2016- down from 37.7 before Lupron. His words "one day the cancer will defeat the Lupron, when that occurs, you will continue to receive the Lupron along with other medication. Our (Duke) findings are that the Lupron serves as an enhancement to the other drugs, making the new drugs more effective"
Wishing Harley the best of every possible out come.
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