Casodex (Bicalutemide): I have been on... - Advanced Prostate...

Advanced Prostate Cancer

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Casodex (Bicalutemide)

tony85 profile image
20 Replies

I have been on bicalutamide 50 mg for the past six years and has kept my cancer in check. I take it for two months and then discontinue for three months and then take it again for two months. It is cheap has no side effects other than breast swelling. I can't understand why other sufferers from prostate cancer do not use this medicine. Originally I was given a three-month shot of Lupron and it nearly killed me the side-effects were terrible.

I was diagnosed as Gleason score 3+4 and my PSA was 34. After taking bicalutamide my PSA goes down to about 1.5 and then it slowly rises. I recently had an MRI and it indicated that the cancer had not spread beyond the prostate gland

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tony85
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20 Replies
AlanMeyer profile image
AlanMeyer

Tony,

Have you attempted curative treatment, e.g., surgery or radiation, or has bicalutamide been your only treatment? If the cancer is confined to the prostate gland, and if you are not likely to die of something else in the intermediate term future, you might want to try surgery or radiation.

As for bicalutamide alone, my understanding is that most men with intermediate or high risk disease don't do as well as you have done on bicalutamide alone and that most live longer on Lupron. Also, 50 mg doses of bicalutamide are insufficient to control their PSA. 150 mg doses may work, but they may have significantly more side effects than the dose you're taking.

However, it looks like you have chosen to try minimal treatment and the plan has worked for you. More power to you. I hope it keeps working for years and years.

Best of luck with it.

Alan

tony85 profile image
tony85 in reply to AlanMeyer

I had radiation treatment but the cancer came back after about one year. I think I'm very lucky because I have no insurance and no healthcare. I could not possibly afford any other treatment except Casodex. My friend was on the same treatment as me for a long time but now he has to take zyrtiga. He gets it for free. If I have to eventually take this medicine I can get it from India for about one-hundredth of what it costs in America.

Jollyjill profile image
Jollyjill in reply to AlanMeyer

My H is on 150 mg /day & has been for over a year. No side effects except swollen breasts which he hates. He’s going to do Proton Beam in July.

Tall_Allen profile image
Tall_Allen

You can prevent breast enlargement by taking 10 mg tamoxifen with it. Raloxifene seems to interfere less with testostosterone production than tamoxifen and may give you better vacations.

tony85 profile image
tony85 in reply to Tall_Allen

thank for the info. I will try and get some from India where it's probably very cheap.

CalBear74 profile image
CalBear74 in reply to tony85

How do you contact your Indian source? Can you provide the details? Thank you.

tony85 profile image
tony85 in reply to CalBear74

Just Google the medicine you want and then put India after it. You will get many replies. There is a website called India Mart and they will direct you to different suppliers. My experience of them is far more positive than dealing with the Canadian pharmacies charge you 10 times the price. Most of them source medicines from India anyway. What I like about them is that I use PayPal. This ensures that I'm dealing with genuine and honest suppliers

CalBear74 profile image
CalBear74 in reply to tony85

Very helpful info Tony. Thank you!

CalBear74

407ca profile image
407ca in reply to CalBear74

I have dealt with All Day Chemist for years.

CalBear74 profile image
CalBear74 in reply to 407ca

Thank you 407ca.

CalBear74

Well, our PCa type is specific to our biology. The treatments are blanket coverage, just like aspirin for a headache, no personalized medicines in our lifetime.

I've read many clinical trials reports and PCa journals, as well as the amazing posts here. The only "take away" I've abstracted, is PCa treatments are best when loaded up from Dx onset!

For every added treatment modality, cancer cells will require exponential mutations - hence, extending life, not a cure...

Notsdr profile image
Notsdr

Tony,

With your GS 3 + 4, perhaps you only had a small proportion of Gleason Grade 4. The low dose bicalutamide has been very effective for you at keeping in check a relatively non-aggressive cancer. I refer you to an anecdotal study of a man with "well to moderately differentiated prostate cancer (no gleason score was available), who was pT3a, initial PSA of 19.2, who, at the time of the publication of the Article in 2015 , had successfully used intermittent low dose bicalutamide for 18 years.

See hindawi.com/journals/criu/2...

As noted above in others' replies, this treatment protocol does not work for everyone, which is not a very surprising statement because it applies to all prostate cancer treatments. Other men have told me that they could not tolerate their side effects on bicalutamide. I have used it for the past 4 years with a GS 4 + 4 (DX age 52, 2008, PSA 135, pT3bNOMX, RRP, SRT, PLND) however, the on off periods have progressively shortened, and PSA nadir has risen from about 8 to 35 (an "effective" PSADT of 2 years, compared to my actual PSADT in the off periods of 0.6 months). Resistance has clearly set in. I have managed to avoid all LHRH agonists and antagonists to date, and for as long as possible, which is my personal objective. I can't say whether my prostate cancer specific survival will be longer or shorter compared to other treatments I could have had, but from a clinical trial median results standpoint, the odds are good that mine will be less. I pretend I am not the median : - )

Richard

tony85 profile image
tony85 in reply to Notsdr

Very interesting. I did read an interesting article on the Internet saying that the difference in survival between LHRH and Casodex monotherapy was about six months. I certainly would rather live six months less than suffer the effects of LHRH. Anyway I'm getting on for 88 and have a lot of other medical problems so I'm not too worried about my prostate cancer.

I am also on Cassodex daily 50 mg for the last 6 years.. My psa is now 1.5 with another test on Monday. My new MO says crazy not to go on Lupron. What are your opinions? All of your input is so helpful.

Thanks Tom

tony85 profile image
tony85 in reply to

I am not a doctor, but I have a lot of experience with prostate cancer. I would say that if Casodex is working so well for you, I would continue it. You are doing much better than I am because my PSA never gets as low as yours. Why should you take Lupron? it could give you terrible side-effects like me. I do not trust doctors on the whole. Many are motivated by profit they can't make any profit on Casodex because of the generic version costs only a few cents, whilst if they administer Lupron their profits can go into thousands of dollars.

in reply to tony85

Thanks Tony - I just don't know at what level of PSA I should switch to Lupron. I have 4 bone mets, that I have had for 4 years and they are not spreading either. Appreciate your thoughts.

ARIES29 profile image
ARIES29

I had lupron & the side effects were terrible as we all know & with casodex, PSA went down to 1.6 but the headaches were the end of it for me.

The reality is the PSA always climbs again & all we are doing is gaining time.

My hopeful treatment now is LU-177. PSA 5.6 from 20 & going for round two in couple days.

Keep on Keeping ON!

tony85 profile image
tony85 in reply to ARIES29

I did not think headache is a side-effect of Casodex. Are you sure it wasn't from something else.

ARIES29 profile image
ARIES29 in reply to tony85

Tony 85, I had a cocktail of drugs at the time,casodex & tamoxifen for the man boob thing & then some specialist put me on duramine to loose weight,saying the T is hiding in the fat.

Obviously that mixture was the cause of headaches & memory loss & the Luprin was the cause of the big stomach & fatigue.

Now i feal good, not taking any drugs & going back to the gym. Second LU-177 in 3 days.

20PeteG16 profile image
20PeteG16

Tony85.

I am THERE with you.

Pete

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