Firmagon?

[AuburnAngel]

It has been suggested that my husband would start hormone therapy with a 1 month shot of firmagon. How long does it take before it starts to take effect? You experience side effects? What has been your experience with firmagon? Any tips on how to make it any easier?

[Chiquis]

My husband started Firmagon, Zytiga and Prednisone in September 2017. Side effects from Firmagon were pain and swelling in the injection area (belly) for about 2 days & hot flashes. He uses a hand fan to help with hot flashes. The best to you both.

Erika.

[Emak1]

I am on a 7 month program, 7 treatment shots in total. First round is a double shot. Then one shot per month. The shots are in abdomen.

2 key things I would mention

1) Make sure the RN giving the shot is experienced. There is a specific way to provide the shot. I had it done at Sloan Kettering, first three rounds, all I experienced as a day or two of mild discomfort. Was exercising the next day with no issue.

2) Diet and exercise, this is for any ADT. I try to stick to a plan and so far (and I am early at 12 weeks in) only had mild 'warm flashes' at night.

As my oncologist said 'Firmagon is top shelf' meaning your testosterone will be 90% reduced in 48 hrs.

Wish you the best of luck.

[Joes-dad in reply to Emak1]

Your oncologist was spot on...or I should say he might have been. I can't speak for my testosterone after 48 hours but one month after my 1st Firmagon treatment, my psa had dropped 95%. I'm looking forward to seeing the number after 2 months...I've added in Zytiga and prednisone after the 1st treatment so it won't be a true test...still looking forward to it though.

[AuburnAngel in reply to Joes-dad]

What is the strategy with adding in the zytiga and prednisone later? This was included in the med oncologist online note:

"Discussed use of docetaxel in this situation, a la STAMPEDE and CHAARTED trials, and its survival benefit. Other option is Zytiga/prednisone a la STAMPEDE and LATITUDE trials which would be more convenient and perhaps more appropriate for N1 disease, although may greatly exacerbate his co-morbidities of DM and HTN."

I think at this stage the brain is on over load trying to take it all in an remember stuff, so sometimes I feel like I'm repeating myself. Of course having a traumatic brain injury doesn't help things but I have lots of notes.

[Joes-dad in reply to AuburnAngel]

In my case, my urologist started me on Firmagon almost a month before I had my 1st appointment with my medical oncologist. After reading thru the STAMPEDE trial results (found on this forum) I discussed adding the Zytiga & Prednisone to my treatment with my MO. He agreed. I'm currently doing all of this at the same time.

[AuburnAngel in reply to Emak1]

Glad to hear your positive feedback. I'm also interested in hearing more about the rest of your program and why they chose to stick with firmagon over switching to Lupton after the 1st shot?

[Emak1 in reply to AuburnAngel]

I am on a short term program so we are going with firmagon. Starting salvage radiation soon. Then it all wraps up in June and we hope for the best

To be honest. I know the shot every 28 days is a hassle compared to 3 and 6 month Lupron shots. But if my side effects stay this way. I am sticking with the firmagon if I need to go back in the future

[Joes-dad in reply to AuburnAngel]

I can't explain it but right now my urologist has me scheduled for a total of 6 months worth of Firmagon treatments. After that we would discuss switching to the 3-month Lupron shots my MO is suggesting. I'm not having any real side effects so I'm happy to stay on it as long as possible. Others may have different results.

[TEBozo in reply to AuburnAngel]

I stuck with Firmagon for no other reason than I knew that devil but did not know the Lupron devil.

[JamesAtlanta]

When I received it, my back pain started to improve significantly in 3-days. Really works well and fast.

Best,

James

[Cmdrdata]

I too have just started on Firmagon and Zytiga (a week ago) after a few years of Lupron and Casodex failed to keep my PSA at undetectable level. The first two days after the tummy shots was not pleasant, but now I do not have any issues other than hot flashes every so often.

[AuburnAngel]

Does icing it afterwards help? Or what helps?

[Joes-dad in reply to AuburnAngel]

Yes. My oncologist gave me a "kit" that came with my 1st Firmagon treatment. In the kit was a chemical ice pack to use after the 1st treatment. He said it would keep the swelling down. I didn't use it and only had a little swelling and soreness the next day.

[Canoehead]

Been on Firmagon for 4 months now. Hot flashes, night sweats and no erections come with any ADT. The pain/swelling from shot is nothing..

You should be on Chemo or Zytiga also. I opted for Docetaxel. My second opinion would have started Zytiga at same time as Firmagon. Opinions can be like a—holes;: there are a lot around

[AuburnAngel]

How do you decide between the secondary treatments?

I'm interested in hearing what others do regarding the ED part and their relationships with s. o.?

[Wassersug]

Dear AuburnAngel,

You and your husband can take the free 1.5 hours ADT class, which covers side effect management for drugs like Lupron and Zoladex. In Canada anyone, who takes the class, gets a free copy of our 2014 book "Androgen Deprivation Therapy".

The class is ideally for folks just about to start on ADT...and their partners. I believe there are still slots open for the March classes. Check out LIFEonADT.com for details on how to register for the class.

[AuburnAngel]

I'm not in Canada but on the other end of the rocky mountains in Colorado.

[leswell]

This April 15, it will be two years since Leswell had a double shot of Firmagon the day of diagnosis. There was a slight soreness following. Very effective. Wthin a month the PSA went from 1500 to 900, not a 90% reduction, but significant. Since that time he has been on monthly Lupron (with one attempt at a vacation during which the PSA soared). Presently he is on combined ADT including a Vantas implant and Casodex. We had the complication of Stage Two bilateral lymphedema which you do not want him to get and which must have resulted from some injection or other. All these were given at a local clinic, not MSK. I agree with Emak1’s advice about experienced shot administration. One of Leswell’s assistants was a trainee. Back pain is worsening, but radiation may not be possible because of the threat of Stage 3 lymphedema.. Go well both of you. Mrs. S

[Hidden]

My first shot was Firmagon, ok PSA down immediately. Then switched to Lupron from drs orders. I did orchiectomy 9-16 , so no more shots. But I’m on another test drug Tak-700 until failure. I am not bragging rather just planely stating that it is possible with luck for your man to knock it down . Stage 4 is not to be taken lightly, time is of the essence. There will be side effects . Some seam to do better than others. I did a 360 life change. I was close to death with kidney failure.If I can get to a better place then so can he. We have to be our own mechanics constantly maintaining this ol car for as long as it’s got wheels. I pray for you both to love each other and lean on each other . Thank God for our wife’s! I know you will watch over him.

[Grandude58]

I took Firmagon from the start (2 years ago) psa went from 26 to 0.15 in one month but started doubling every two weeks after just 3 monthly injections. Stayed on it regardless for 3 more months. At that point I discontinued and for the next 7 months my Testosterone level was steady @ below 15. That tells me that once a month injections are way overkill!