Bicalutamide 50 to 150 mg

[Zach58]

I recently was castrated and began taking 50mg Bicalutamide daily which I will titrate to

150mg over a 3 month period. This case is based on th CPCG-6 study results published in February 2015 and entitled," Survival benefit of early androgen receptor inhibitor therapy in locally advanced prostate cancer: Long-term follow-up of the SPCG-6 study"

Anyone else following this protocol?

[ctarleton]

Not me, but here's a link to the abstract of the referenced Scandinavian Prostate Cancer Group study which was published in the European Journal of Cancer:

ncbi.nlm.nih.gov/pubmed/258...

[Zach58 in reply to ctarleton]

Thanks for the link

[Hidden]

I'm not doing it either, but it has worked for some.

You have to watch your liver functions with that high a dose and the dose can also accumulate if you have hepatic impairment. Another potential issue is the PCa through mutations, can end up feeding off of the Bicalutamide. If you are keeping a close eye on your PSA you would see that. If that happens, your PSA often goes down when you stop.

Good luck with your treatment and let us know how it goes.

[Zach58 in reply to Hidden]

agreed

[paulofaus]

In the study you referenced, it says "the addition of early bicalutamide to standard of care resulted in a significant OS benefit in patients with locally advanced PCa" the bicalutamide arm had 70.5% of men die, while the placebo arm had 71.1% die over the 14.6 years of the study. That doesn't seem like significant difference to me, or am I missing something? Shame they didn't test men with metastatic disease to see if there was a difference.

[Notsdr in reply to paulofaus]

It is a little confusing, but the way I read the conclusion, it was of little OS benefit for non-locally advanced PCa, but "significant" benefit for locally advanced PCa. The authors did not state what the "significance" was in terms of percentages (the percentages they reported were not for the subset of locally advanced PCa), and I assume the underlying data would have that information. The Report should have stated those percentages too so we could determine for ourselves whether the difference was in fact "significant" for locally advanced PCa.

[Sisira]

For me the conclusion is confusing compared with the results! Overall 866 have died over the 14.6 year period, 428 ( 70.5% ) in the bicalutamide arm and 438 ( 71.7% ) in the placibo arm. I don't see a significant difference. I am also aware that a high dose of bicalutamide ( 150mg ) is likely to cause significant side effects such as liver damage, cardio vascular issues and depression if used over a long period.

Sisira

[pjoshea13]

You are castrate, but dihydrotestosterone [DHT] can be made via a pathway that does not include testosterone. Avodart will halt current/future DHT production.

The cancer might start making androgen from cholesterol, so it's prudent to use a statin IMO.

-Patrick

[Zach58 in reply to pjoshea13]

I appreciate your comments - I am currently taking Crestor. Please offer any other suggestions.Thanks

[pjoshea13 in reply to Zach58]

Zach,

Crestor (rosuvastatin) is hydrophilic. Perfectly fine for non-PCa purposes. But a lipophilic statin is best for PCa. I use Simvastatin, but there are others:

"Atorvastatin, lovastatin, and simvastatin are lipophilic, whereas pravastatin, rosuvastatin, and fluvastatin are more hydrophilic."

"In terms of lipophilic nature, lovastatin and simvastatin are the most lipophilic, followed by atorvastatin, fluvastatin, and pravastatin. Rosuvastatin is a relatively new statin, having a polar methane sulfonamide group, and it can be placed between fluvastatin and pravastatin." [1]

-Patrick

[1] pharmacytimes.com/publicati...

[Zach58 in reply to pjoshea13]

appreciated will check into switching

[Dan59]

Casodex (Bicalutamide) 150 is the only dose of any drug through last 11 years that caused my Liver Function test to rise to 3 times upper limit of normal. The other liver toxic meds I could tolerate well were , Nilandron , High dose Ketoconazole, zytiga , xtandi , and chemo. Be sure to watch your liver numbers while on bicalutamide 150

[Zach58 in reply to Dan59]

Thanks for the info.

[kjscobel in reply to Dan59]

I was prescribed Casodex when I was first diagnosed with PCa. Like you, it impacted my liver readings 5x normal. It took 6 months for my readings to return to normal.