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Advanced Prostate Cancer
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Effects of casodez

I've been on Lupron for 2 years. Went on Casodex last month. PSA had risen from 1.5 to 3.4. Very small mets in pelvis, but at my age 79, Radiologist thinks the CT scan could be showing effects of arthritis. Oncologist agrees. Radiologit wants me to have radiation of the breasts to prevent swelling and tenderness caused by casodex. Does anyone have experience with this? Thanks

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Got Casodex to add to Lupron after several years. Had immediate pain in hip and down left leg very similar to that prior to replacement of other hip 12 years ago. Celebrex first thing in AM prior to all other drugs helped a lot. Hydro codone when needed rest of day.


Radiation to the breasts is a common pre-treatment used to stop breast growth (called gynomastia) resulting from Casodex. Along with the breast growth you could also experience pain, sensitivity and for some men some embarrassment. Having the radiation is optional.

I elected not to have radiation because I remain concerned about the possible increase of risk for secondary cancers caused by the radiation (please be aware that there is NO evidence that this radiation does increase risk, but I still remain concerned and will error on the side of caution).



I started on estrogen patches for hot flashes 2+ years ago. Saw radiation oncologist about pre-treatment radiation to my breasts. Like Joel I opted not to have any more radiation. My breasts were tender for about 6 months. I wear a swim shirt when at the pool which also reduces sun exposure. Otherwise no one notices my gynecomastia.

I just started Casodex this week and I cannot imagine much more breast growth than I got from estrogen. My PSA is 1.64 with a doubling time of 12 months. No bone mets.



Your mention of estrogen patches for hotflashes from Lupron reminded me of an area I forgot in an earlier reply: Use of estrogen, as patches or creams, IN PLACE OF LUPRON OR lupron/casodex. Richard Wassersug is the big proponent of this. It has received more acceptance (trials) in England than in US. We seem preoccupied with the risk of blood clots--which have not been reported as a problem with patches; that concern seems to go back to diethylstilbesterol (DES) as the early "hormone treatment". But getting US docs to embrace estradiol patches has been slow.

Estradiol patches also provides bone density protection so no bisphosphonate is needed.

I'm sure that the difference in cost has not been a factor :-)

Herb S.

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Want to add the following:

a. If you're concerned about Lupron side effects, look up Casodex-it ain't baby powder!

b. Since I just re-started Casodex yesterday in anticipation of my 4th Lupron cycle, I checked some aspects out:

Casodex shelf life: 5 yr!..

Half life 5.9 days. Does that mean I should be able to take it every other day...or even farther apart???

Reaches steady state plasma level of 9 ug/ml with daily dosing.


Great questions. Has anyone thought about titrating casodex. Doctors usually offer suggested doses. We've always tried to moderate the doses and have done well. Never even considered casodex.


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