Advanced Prostate Cancer
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Casodex and ADT

Hi all,

It seems to me that most newer treatments in pill form, come along with Prednisone. I understand this is for the side effects from said treatment.

Where does Casodex fit in? I've been on Lupron for six years, and had one ninety day course of Casodex during this time. And this was recent.

I'm wondering if this may have been another screw up by my previous uro.

Thanks, Joe

4 Replies


Casodex is used as a hormone therapy (ADT) either separately at 150 mg/day (in the UK) or at 50 mg/day (in the U.S.). Casodex blocks testosterone from being able to access the cancer cell to feed it.

Casodex should be started (in U.S.) at least 10 days prior to getting drugs like Lupron that stop the testis from generating testosterone. Some doctors will stop Casodex some time after the Lupron shot and other continue it along with the Lupron.

Casodex (aka bicaludamide) does have a nasty habit of reversing its action and feeding the cancer. So, if you are on Casodex, castrate and your PSA begins to climb the first thing to do is stop the Casodex and see if that reverses the PSA trend.



Joel, I was having this discussion with another wife recently about the time one needs to be on casodex prior to say Lupron.

Initially, 9 years ago, for the first round, it was 10 days prior to a Lupron shot. We actually had an 8 month success and then the PSA began rising. We immediately went off casodex and it dropped down without a rise after that for another year....

My question is, when we've begun the on again and off again Lupron, our oncologist has given us a 3 day or 5 day casodex. These are well informed oncologists- so, can you speak about the 3 day or 5 day. I thought possibly the first round with the 10 day casodex may have been because it was the first round- then I assumed the protocols changed over 9 years, and/or our intermittent use caused the difference in days prior.




The protocol still is to start 10 days prior to Lupron, my guess is that the doctor is shorteming it because of his prior negative result. I would ask why the doc is doing it this way.


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Elgie started Casodex before his 1st hormone injection and has been on it continuously. He does not have a cancer producing PSA.



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