Casodex Discontinued to start Taxotere

[chumpup]

Hello! My "strong as a bull" father was diagnosed in January 2017 with StV Prostate Cancer, dense prostate full of cancer + liver mets confirmed on Helical CT scan (only). PSA initially 1300. Started immediately on daily Casodex and then opted for an orchiectomy in early February. Since his PSA is 268. His urinary symptoms (which are his only major symptom) have diminished, but not disappeared. He has opted for 6 cycles of Taxotere, to begin April 18th. He has remained on Casodex, and we received a call yesterday to stop the Casodex and delay 1st Taxotere x 4 weeks (pushed to April 18). Working with Drs out of Shadyside Hospital/Hilmann Center. Thoughts on stopping Casodex? Urologist says no issue, "Casodex isn't doing much after orchiectomy."

[chumpup]

Forgot to mention, Dad is 66 on no medications, healthy "never willing to retire" construction and plant worker. Screening colonoscopies and knee arthroscopies only as his PMHx. Mom died of colon Ca, Sister had Breast Ca, my sister/his daughter had a brain tumor caught at StII surgically removed. Healthy today.

[Dr_WHO]

Welcome and sorry that you are here. You are right, the primary role of casodex is to suppress testosterone. The need for it now may not be that great.

Keep hope.

[eggraj8]

I was briefly on Casodex and ADT. When my Testosterone was reduced I was taken off Casodex and stayed on ADT. With the orchiectomy your father should have low Testosterone and may not need the Casodex anymore.

My PC has also spread to my liver and my oncologist says that if it is not controlled in the liver it is likely fatal. I am currently on chemotherapy (Taxotere and Carboplatin) along with ADT. My prostate, bone, and lung mets seem to be responding to this but it is not clear whether the liver is responding. I will find out when my next CT scan is done next week. If my liver is not responding then different chemo drugs will be used.

BTW my PSA was always much lower than your father's. When first diagnosed it was 2, after the cancer spread through the lymph system it reached a high of 25 until being controlled by chemo. It is now 4.

Dick

[RonL]

I've never known anyone who has had an orchiectomy but what others said here about the Casodex is probably correct. I am surprised he wasn't offered Zytiga or Xtandi. These are ADT treatments used in CRPCa (castrate resistant prostate cancer) that inhibit androgen produced by the adrenal glands and the tumours. Of course his doctor may have good reasons for going to chemo therapy first but I'd mention this to him.

Good Luck

Ron

[Hidden]

I was given Casodex at the very beginning of treatment for 90 days, that was it. The website says it's for D2 metastatic disease. So, I'm thinking seven years later, I'm well past that staging.