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Advanced Prostate Cancer
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Blood Clots with Lupron

One of my local support group spent Christmas in the Emergency Ward due to a blood lot. At our meeting a couple of days ago he had some information about a Swedish study which showed patients on lupron had two and a half times the likelihood of DVT (deep vein thrombosis) and twice the likelihood of pulmonary embolism than the general population. First I'd heard of that. Does anyone have more information?

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Here's a recent meta-analysis. Even with a greater risk, the risk is still low:

nature.com/articles/s41391-...

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Thanks, I've been on lupron for a year and a half now and since I'm castrate-resistant I'm starting to question why I should continue. But since I haven't had any blood clot problems so far I don't think I'll worry too much about that. I have been on lisinopril, which is an ACE inhibitor for several years and it's working quite well on my blood pressure. Don't know if there's any connection.

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Castration-resistance is a relative term - in fact, the androgen receptor multiplies so that even the smallest amount of androgens can activate it. Without Lupron getting rid of the bulk of your testosterone, the cancer cells would grow at a faster rate.

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They're doing pretty well as it is. Don't know where they get the stuff, but they do. I really have to admire my cancer. It can take whatever they throw at it, chew it up and spit it back out. My cancer is tough!

Fortunately I'm kind of a tough old buzzard myself so the cancer and I are at kind of a standoff right now. Both jockeying for position. It's quite a fight.

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Last February, I had a pulmonary embolism and ended up in the hospital over night. According to the doctors, when you are getting ChemoTherapy, there is a high risk of developing blood clots. I now take eloquist twice per day. Eloquist is a blood thinner. I don't know whether or not Lupron increases the risk of blood clots. I've been getting Lupron shots since 2013 every 6 months.

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u know lupron/eliguard shots only benefits your testosterone not anything else. so after 5 years have it kept the mets down and lowered your psa?

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I rely a lot on my Doctors expertise for the treatments I receive. During the time I have been on Lupron, I have received various treatments in conjunction with the Lupron shot. When I started getting the Lupron shots, the cancer had already metasized to my bones. Overall my PSA has stayed down. When we see it start to rise, we move on to the next available treatment. Currently, along with the Lupron shot I get a ChemoTherapy treatment every 3 weeks. My doctors plan is to do this with the Chemo where I get Chemo treatments for 3 months then with 3 months off. We'll see how it works. I feel pretty good about it as long as we can keep the cancer under control and getting a break should make me less toxic.

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This should be helpful:

ncbi.nlm.nih.gov/pmc/articl...

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"Cardiovascular

Very common (10% or more): ECG changes (19%), ischemia (19%)

Common (1% to 10%): Hypertension, murmur, phlebitis, thrombosis, arrhythmias, angina, myocardial infarction"

drugs.com/sfx/lupron-depot-...

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Thank you. One of the problems is to identify the source of a symptom. Is it a medication side effect, the cancer itself, some other medical problem or just that I'm 76? And it can be a toss-up.

I'm not worried about cardiovascular, however.

"My heart's in the Highlands

My heart is not here.

My heart's in the Highlands

Chasing the deer.'

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Sure, it can be hard to decipher with some people. But, when the effects come on within one shot of firmagon, two of Lupron at the age of 62 (now 63), then some things are obvious. Unfortunately, my husband fits in the cardiac effects...severe. The cancer does not cause severe atheroclosis or cardiomyopathy. My husband did not have “metabolic syndrome” when on ADT, all levels are normal, we can’t blame that. Fortunately, he is off the lupron and our God only knows the time of his death and how. So, we rest in this truth. Currently, he’s feeling well.

The effects are in the literature, these things are not uncommon.

Thrombosis while on Lupron is common as stated in the literature.

The best to you as you navigate this maze of how much is too much for you.

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for me i went with the 6 month shot which fits me better then the month shot. as for me no problem other then the shot was a big pain for me. i rmember when it was a sub-cute shot in the stomach no pain and no problem.

charlie

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Cancer itself has a profound effect on coagulation factors. Several studies have suggested that when an otherwise healthy man presents with a DVT, that he be screened for PCa. A blod clot can be an early warning of PCa (or other cancer).

Does ADT further increase that risk?

From: "Androgen Deprivation Therapy for Prostate Cancer and the Risk of Venous Thromboembolism.":

"The use of ADT was associated with an overall 84% increased risk of VTE, with the risk elevated for most ADT types."

ncbi.nlm.nih.gov/pubmed/?te...

I have a series of posts on blood clots. The D-dimer test can be used to check for a clot. If D-dimer is close to zero a clot can be ruled out. D-dimer may be elevated for other reasons, but it is prudent when cancer is present to assume that a clot may be present. Nattokinase will accelerate removal of the clot.

Men die in the ER every day from clots that have broken off & moved to the lungs (including by brother-in-law). It seems foolish to me to ignore the risk on the basis of the risk being small, when the consequences can be dire.

-Patrick

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My comments on DVT. (With 6 bits you might get a cup of coffee): before I would look at Lupron, I would look at the most common risks; especially for anyone over the age of 40; certainly by age 60. All risk factors for DVT are also more common with older age.

Immobility and dehydration. After four hours of cramped travel, you have double your risk for deep vein thrombosis for several weeks! (The major reason that I stop driving after an hour and walk around for several minutes.)

Family history. About 5 to 8 percent of Americans have some form of thrombophilia. Having had a DVT in the past is the single biggest risk factor for having another DVT! From Dr. Alan Lumsden, Chief of Heart and Cardiovascular Surgery at the DeBakey Institute, “Having had a DVT in the past is the single biggest risk factor for having another DVT.”

Obesity. Anyone with a BMI over 30 will have about two to three times the risk for deep vein thrombosis as a person with a normal BMI.

Physical Trauma or Injury. Any trauma, from surgery to an auto accident or a simple fall, may trigger the body's blood clotting function, and a deep vein thrombosis may form within a few hours or up to a few weeks after the trauma. Did you know that up to 80 percent of people having an orthopedic surgical procedure develop a deep vein thrombosis.

With all this said, Lupron is the best method of reducing testosterone in the treatment of Advanced Prostate Cancer. Talk to your Cardiologist and find out what steps you can take to ward off DVT.

Gourd Dancer

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Resepctfully, it’s irresponsible to remain in denial of the side effects. It is in the package insert and numerous reputable articles that one needs to be monitored for cardiac and blood clot effects. Most men are not monitored on a consistent basis. Sure, if one is over weight (BMI) or had a trauma, or recent surgery, then by all means look at all of those things but most definitely Lupron has to be investigated as a player.

Lupron is great at reducing T, there is no disagreement here.

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Didn’t say it was not a factor, but there are major factors with greater multipliers. Boils down what risk one is willing to undertake to prolong life. I have been most fortunate to have my Cardiologist talk with my Medical Oncologist and Orthopedist when called for. In 2004, I took the risk with a six month chem-hormone therapy trial one year out from a double by-pass for an aortic aneurysm. To me it was a simple decision -wait 2-4 years to die or try and kick the bastard down. My point is to cover your bases and do what your specialists tell you to do to reduce DVT and pulmonary blood clots after you weigh the risk of keeping testosterone at bay.

Frankly people die. Let it not be because of a fear of Lupron or a fear of chemotherapy; and any side effect of treatment. With that said, it’s your life and any decision which you make, it is good decision of you; as long as your are informed. Even as what some may call foolish, the drinking of urine as a cure all.

I wish all the best.

Gourd Dancer

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I'm not in disagreement. I'm beng realistic with the facts. It's not fear that is driving my thoughts here. It's a fact that Lupron is a player in these things (in response to the OP). That's all I'm trying to get across.

We are still working on getting our cardiologist and oncologist to connect, until then, both agree a vacay from lupron is best.

Glad to hear you are doing well.

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If not on a prescription blood thinner I wonder if just daily low dose aspirin use would reduce the risk of DVT in the kind of plane trip situation you describe. I always take a bigger dose aspirin when I board a long flight which isn't very often at all these days but I do have such a flight in May.

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Yes, what is the cause? 68 and a half. Taking lisinopril for many years. Blood pressure higher than usual last 2 months. Maybe when I started celebrex? About 3 weeks ago lower left leg swelled up. Saw MO Monday Jan. 14 and had ultrasound same day. No clot found. Juggling my meds, but who knows if it is even meds. BP still way high, swelling somewhat better. Will make an issue of BP when go in for Xgeva shot this afternoon. Many mysterious side effects since this journey began. Could be caused by sitting at this computer and being on HU for too long. Gained almost 30 lbs. after quitting smoking at end of Aug. Wonder how many people have died from quitting smoking. Yes, what is the cause?

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Yep. Heck I gained 90 pounds after six months of a chemo-hormone therapy trial with 30 mg of Prednisone daily........ the answer, for me at least, was to hire a Personal Trainer who specialized in weight loss of people with cancer and cardiac issues....... it’s a journey. How one travels is their decision.

GD

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Fact is that all of the people who died from giving up smoking have eventually died from death.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 01/22/2019 1:04 PM EST

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Hello Stegosaurus37, I was on Lupron/Eligard for 6 1/2 years. My oncologist explained to me that when a cancerous prostate cell breaks off from the prostate gland and enters the circulation it has affinity for the bones and lymph nodes. When it attached to a bone it sits there, then sinks into the bone, leaves a pock mark, and is trapped there until it dies if there is no testosterone. Androgens (like testosterone) stimulate the cell to multiply and without androgens the cells simply die of old age. They do weaken the bone and I received 3 shots (one every 6 months) of Xgeva and osteoporosis drug. Right now I am on active surveillance and my PSA is 0.006. It has been 9 months since I had any therapy. So the Lupron kept my T levels low and stopped the formation of tumors in my bones. I wish you well and hope you just keep on truckin'.

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