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Advanced Prostate Cancer
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Vantas insert for ADT

I am trying to find anyone who is using or talking to their dr about vantas insert, which uses a drug histrelin , which is comparable to Lupron from what I understand. Seems like almost all use Lupron for ADT

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When I was diagnosed with Gleason 8 PCa in 2009 my urologist inserted a Vantas capsule in my upper left arm. Like Lupron it's an LHRH antagonist and It worked fairly well, bringing my T down to the same levels one would expect from Lupron. Since it lasts a year, it was better than getting Lupron shots every few months. However, when it came time to get it out, my doc could not locate the capsule even though he dug around in my arm for a while before giving up. He's a pretty decent surgeon so I don't think it was incompetence on his part. Eight years later I assume it's still in there but it has certainly not caused any ill effects. But you may want to have a discussion with your doc about what he/she plans to do when it's time to remove it—or even if it needs to be removed.

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Thanks

The Vantas site says that in the case it can't be found simply, they say to use scan to find it

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How were your side effects; did you get a good PSA and Testosterone response?

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Sounds like unlocatable Vantas capsules is not an uncommon problem. The side effects of Vantas were pretty much the same as any other form of ADT. In my case, hot flashes and loss of libido, as well as osteopenia. PSA went down (although it was only 1.5 at diagnosis—but that's another long story) but T only went down to 32 by the year's end. Since I was on a 3-year ADT course, my uro switched me to Firmagon, which reduced T to under 10. But as they always say, my results may not be typical.

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I have had Vantis implants for the past 11 years. Never a problem removing it for a new one to go in. Side affects are no worse than shots every 3 months. Still alive, can't any better than that.

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Thanks

Looks like you also have an engineering background. I also was diagnosed with relatively low PSA, its velocity made me push hard for biopsy, Gleason 4+3. I like the logic you utilized; u r also a brave man after reading how u handled your bone met with surgery, to eliminate uncertainty.

I understand the results were that wasn't a Pca met-glad to hear that

What concerns me with our low PSA with aggressive Gleason scores is the development of neuroendocrine or small cell Pca , whose emergence apparently increases under the pressure of ADT treatment.

My doc took an unusual course and put me on Xtandi, which was ramped up then down, with PSA going undetectable as soon as the Xtandi was started. The Xtandi start date was feb 2016 and has stayed there, now down to 3 Xtandi per week.

My concern is the evolution of the inevitable resistance, which would prob be from changes to AR, and/or mutation to neuroendocrine , which doesn't produce PSA

Don't know if take anything else; I was put on metformin and avodart.

Much luck to you

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Don't know if take anything else; I was put on metformin and avodart.

How did you prevent your glucose from falling too low; while on metformin? What dosage were you on?

Rich

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I had it done some years ago. It is an osmotic pump. My tiny device was about the size of a spring inside a ball point pen. The drug is in it and the movement and pressure of fluid in the body slowly presses the drug into the bloodstream. My second one in my second year of treatment was the first time testosterone was tested and the level was 52 which is too high. I switched to Zoladex and things went better. I can understand that if trips to see a doctor are uncomfortable, expensive, time consuming then the annual insert could be the answer.

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Well I am on my second--Doc found my First on, removed it. And got a new one. During my first 15 months, my T averaged about 20. On my second one my T is averaging 10. I get very minimal side effects---as associated will male menopause, the only side effects i get are associated with the removal/loss of T. My Doc. over the years has implanted near 500 patients. He will offer the shots, but always points you to the Implant. Cost is 3600 dollars, paid by Medicare. Insurance is an individual issue. I went to undetectable PSA, after failing Surgery and not being able to have Radiation or Chemo--as my PC escaped the capsule, and went swimming in my blood. Undetectable to get their took 6 weeks with Casodex. And have been there ever since by the Grace of God. At 3 years I may venture out and try going without the Implant and Casodex--but keeping the Avodart& Proscar--with DIM and Arimidex. This would be to control DHT and E2 as T rises.

Nalakrats

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If you take metaformin, how do you prevent your blood glucose from falling too low? What dosage are you taking?

Rich

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It does not drop too low--the ADT caused it to rise from about 98 to 114, starting to get close to borderline diabetes. The Metformin brought BS down 14 points, now at a nice 100. Did this with 1500 mgs per day. But have moved up to 2,000 per day which is the considered right dose to be effective against slowing aggressiveness of Metastatic PC. By the way there is a time release and regular--I use both; one time release in morning, and one before bed. The regular I use one in the morning with the Time Release, and one regular mid afternoon. I worked this out on my own--and this spread out and use of both the Time Release and the Regular, allows me control. Of course I get blood tests every 6 months.

Nalakrats

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Thank you. I meet with my doctor the end of the month. I will get a metaformin perscription, and discuss having a regilar and time release version.

Rich

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There are other Versions. I just mention the one I use. Seems to be the common one in my part of North Carolina.

Nalakrats

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As you quite thorough, guess you felt that Vantas version was best fit

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No my Surgeon did---having used it on over 500 patients.

Nalakrats

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Glad things are going well for u; you're a good man

How's the renovation going?

Thanks

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Rich

Coincidentally my a1c sugar was a bit high and got benefit of metformin pushing it to upper normal range

Wanting the max Pca benefit I asked for the max my doc would allow-so I am on 2000mg per day

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