Would like to know about Casodex

[dbrooks_h]

What is the reason for adding Casodex for someone who is already on Lupron?

[Grumpyswife]

Casodex was added when Lupron didn’t seem to be working, I.e., PSA stayed level or stalled.

[cesanon]

The reason for the cumulative use of multiple agents that all do the same thing is to extinguish that last bit of testosterone from your system.

I believe also, that some of them work on alternative testosterone pathways.

So by using multiple drugs, when your body attempts to adjust for one blocked pathway by using another pathway, that second pathway is also blocked.

[pjoshea13]

Lupron shuts off testosterone production from the gonads. It does not affect adrenal sources.

Lupron's target is essentially the androgen receptor [AR]. Casodex is an AR antagonist - a nonsteroidal antiandrogen that binds to the AR. It is sometimes used as monotherapy.

-Patrick

[Tall_Allen]

Sometimes adding Casodex will reduce PSA when Lupron begins to fail. They usually try it for a while until PSA rises again.

[jdm3 in reply to Tall_Allen]

What would be the reason for adding Casodex (or remaining on Casodex) when Zytiga has been shown to be better? Start with Casodex until the PSA begins to rise and then switch to Zytiga? Thanks.

[pjoshea13 in reply to jdm3]

Why not both?

-Patrick

[rococo in reply to jdm3]

No one seems to follow this protocol yet it works for some.. Blocking T. Before stopping it. Rocco

[Tall_Allen]

Casodex is a lot cheaper, so why not see if there is a PSA response. It is a less powerful anti-androgen than Xtandi.

[jdm3 in reply to Tall_Allen]

Thanks. My question was because I am Lupron and Casodex too. T = 6 and PSA < 0.02 so very good response. My MO thinks stay with the Casodex for now as it seems to be working. However, Zytiga has been shown to result in a better survival benefit. Thus, I wondered if I should switch sooner than later.... or wait and see how it goes with the Casodex. Another reason to stay the course for now is that I am tolerating the ADT pretty well and Zytiga may introduce other side effects.

[Tall_Allen in reply to jdm3]

Zytiga resulted in an improved survival benefit when given to men with newly diagnosed PC who are metastatic. You are recurrent? So probably it can still add to the survival benefit. You have to decide if the extra side effects (which are not trivial) are worth it.

[jdm3 in reply to Tall_Allen]

Yes, recurrent. One identified met to hip bone zapped with SBRT 12/17.

[dbrooks_h]

Thanks to all of you for the needed info.

[RICH22]

friend of mine described it this way:

Bicalutamide doesn't stop T production. It is a fake T that clogs up testosterone receptors in all the body's cells so the real T can't get in.

They give Lupron to stop T production.

i've been on it for 2 months, but taking tamsulosin with it, which may boost T level a bit but not significantly, according to my urologist.

[RICH22 in reply to RICH22]

or was it the finasteride? so many details, hard to keep track.

[Spitzz]

When I started 17 years ago then it was called triple hormone therapy (THT) Lupron, Casodex and Avodart. The Casodox worked for 15 years and then it was not doing its job. Since then the casodex has been replaced by Zytiga..I don't get down into the molecular details, I'll ride the Zytiga as long it keeps working..

BTW

[larry_dammit]

Gave me the Casodex with prednisone,before my chemo started. Was supposed to stabilize my readings.

[Bloomington]

My husband's MO said that Lupron can initially cause an increase in PSA. Casodex is started a couple of weeks before Lupron in order to prevent this

[flintknapper]

Wrong spot for this but I'm figuring this all out. I did Zytiga in 2014. Only got 7 months.