Lupron and antiandrogen monotherapy to avoid castrate resistant pc and increase survival and better quality of life

[rococo]

When casodex fails to extend off cycle of lupron would exstandi do the same or even the older antiandrogen, nilutamide or even rechallenge with casodex after another cycle lupron This therapy keeps the testosterone intact longer and even raises it during the antiandrogen monotherapy phase thus keeping castrate resistant at bay. Throughout with avodart

[pjoshea13]

Rococo,

When Casodex (Bicalutamide) resistance occurs, it may be due to a mutation of the androgen receptor [AR], where the drug actually acts as an agonist, rather than an antagonist.

This can't happen with Xtandi (Enzalutamide). Further, Xtandi inhibits the AR from moving to the nucleus of the cell. AR can't do any harm if it can't get to the nucleus.

Xtandi has to compete with the natural AR 'ligand' - dihydrotestosterone [DHT] - so it would be prudent to use Avodart, as you suggest, to limit DHT access.

Not sure that I would like to try Nilutamide (Nilandron) [1].

-Patrick

[1] en.wikipedia.org/wiki/Nilut...

[rococo in reply to pjoshea13]

Thanks Patrick, Iam wary of the nasty side effects of nylutamide but it has worked for some who failed casodex. Hope your right about the extandi but at some point it to will will fail to block the. high T. generated from the monotherepy of lt. No one seems to. understand this paradym shift in treatment , not even my 2 previous oncologist. Will try to simplify a new post

[Frankenski]

I never had anything during my vaca time. I only had Casodex once, at the start. I was on intermittent for about five years, and nothing. Should I have been?

[rococo in reply to Frankenski]

Not really.. Yours is standard treatment

[Cantabrigian51]

I was diagnosed in July of 2009, Gleason 8, stage 4 (a single metastasis in my hip). I was given casodex and lupron at the time and my psa continued to rise. I was switched to high dose ketoconazole with a steroid (neither xtandi nor zytiga were available at that time.) My doctor wanted me to have Provenge and I wasn't able to be on the steroid while getting Provenge, so I was switched to Nilutamide in the summer on 2010. I have been on it ever since, along with Avodart and lupron. My last psa was .04. I have, as far as I know, no side effect other than the burdensome ones from lupron - no libido, hot flashes and fatigue.

I don't know if Nilutamide is the right step for you, but I wouldn't necessarily shy away from it because of side effects. It does have a black box warning, but we have a black box disease.

[rococo]

My point is sometimes the nylutamide and avodart alone might work in an off cycle when psa begins to rise as testosterone begins to recover thus keeping your testosterone by not starting the lupron alo0g with it

[rococo]

Thanks nal. Will keep this med in. Backburner

[rococo]

Also love the effect your getting from Nylutamide. Not common but lve heard of its use after casodex enough to consider it. Thanks. Rocco