anyone ever taken zytiga and casadex at the same time

[Racer26]

Had prostate cancer in 5/2011 gleason 8 (3+5) Had Proton 7/2011 On allegard and casadex for the last year and a half. Psa under 1 until 9/18 when it went to 4.8 Oncologist in Illinois told me to stop casadex and started me on Zytiga 10/18 No side effects on the zytiga and psa at 0.86 and testorerone 8 Had PET scan 10/18 and and cancer had spread to pelvis 3 spots. Now in Florida and met with Urologist/Oncologist very good man, He suggested radiation for the bone mets and possibly seeds for the prostate (which is full of cancer) and start back on casadex with the zytiga and predesone. Thank you I have been reading your posts and you are all very good friends to us all.

[Tall_Allen]

Zytiga is usually given along with Lupron or similar - this is the first time I've heard of Zytiga+Casodex. Otherwise, it sounds like a good plan.

[Racer26 in reply to Tall_Allen]

Thanks for the reply I currently had 6mth shot of allegard which will be renewed in May Has anyone had salvage treatment to prostate after radiation?

[Tall_Allen in reply to Racer26]

Here's some info about it:

pcnrv.blogspot.com/2017/09/...

[Racer26 in reply to Tall_Allen]

Thank you for the info

[Hidden]

Casodex was the first med I was started on, in just one week my incontinence and burning sensation of urination was eased, Then Eligard (Lupron) and Zytiga/Prednisone was added soon afterwards, then my doc stopped the Casodex doses, because the effect was not needed anymore. The rationale, lesson meds that are not effective anymore, cut down toxins and cancer mutations.

This is just my treatment experience, just reporting, not suggesting anything, we are all different, make sure the Oncologist is prostate cancer savvy.

[Mkeman in reply to Hidden]

Casodex is usually given for two weeks prior to Lupron or Eligard to prevent a testosterone flare up that happens with Lupron et al. My MO uses this approach. My urologist says Casodex not really needed.

[GP24 in reply to Mkeman]

The guidelines recommend casodex against the testosterone flare, so I do not know why your urologist does not use that. The first Lupron shot will initially increase the testosterone level and cause the cancer to grow. You do not want this to happen, so you take Casodex before the Lupron shot. It you have bone mets, the testosterone flare can cause bone pain!

The alternative to Casodex is a shot of Degarelix followed by Lupron. Degarelix causes no flare and decreases testosterone very quickly.

[tom67inMA in reply to GP24]

My urologist gave me a shot of Eligard the day I was diagnosed, with no Casodex beforehand. My pain levels spiked. My PSA spiked from 216 to over 300. PSA has since plummeted and pain levels are generally improving. I'll never know if it would have been easier with Casodex, but on the bright side it's another weapon that my cancer has never seen, so it should be effective if/when it's needed.

Unfortunately, such decisions are made by the doctor before the patient has any chance to learn about the disease. I wouldn't recommend taking a few weeks to learn before starting any treatment with a metastatic diagnosis.

[GP24 in reply to tom67inMA]

I am sorry, your urologist made a mistake.

[tom67inMA in reply to GP24]

I generally agree, but find that a rather binary way of looking at the situation. Is it so bad a mistake that I should have fired him right away and sought out another urologist? Doing so would have delayed radiation therapy, chemotherapy, and surgery to remove a bladder tumor unrelated to the prostate cancer. I prefer to think of it as my treatment was not perfect / optimal, but so far it has been quite effective overall.

[GP24 in reply to tom67inMA]

My urologist makes mistakes all the time. So I decide on my own how I want to be treated and just ask for a presciption.

I recommend to learn how to treat the disease and not just listen to your doctor only. But I agree you often do not have the time for that.

[tom67inMA in reply to GP24]

Yep, I'm moving in exactly that direction as I learn more.

[monte1111 in reply to tom67inMA]

Yeah I didn't get no stinking Casodex either. And after 2 years I still haven't had my testosterone level tested. But by the way I cry and carry on during the soap operas I guess that doesn't matter.

[tom67inMA in reply to monte1111]

Does getting T level tested really matter if PSA is showing a response? In other words, would knowing your T level affect a treatment decision?

I like the idea of an indirect T test: We'll show you this really sad movie and see how you respond

[Hidden]

I was on bicalutimide (casadex) for a while after my LUPRON shot but when I started with abiretarone acetate (generic zytiga) I was taken off the bicalutimide after a few days as my docs all thought there was so much overlap that the bicalutimide became unnecessary. This might only apply to me, however. I did not have any bad reactions or side effects to any of the three, nor even when they were all together. FTW, I also have a history of extremely bad reactions to anything like prednisone or prednisalone. But with the zytiga I have hadzero bad reactions to the prednisone.