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Advanced Prostate Cancer
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Lupron or not that is the question

I have wrapped up 6 rounds of chemo while taking a monthly Lupron injection since November. My PAA has dropped to a .1, should I take a Lupron break? I have been on and off Lupron for the last three years and it kicks my butt, but it works on keeping my PSA suppressed. Each break gets shorter with increased velocity and doubling time. Should I risk taking a break or suck it up. It has been three years since my RP surgery followed by 38 rounds of radiation with Lupron. Stage 4 with Lymph node Mets.

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Does your break last long enough for your T to recover?

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Right now I get a shot every 30 days. Based on my history I might get three months before my T is decent. Right now it is 7.

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I’m also finding it tough to decide whether or not to continue with ADT on its own – in my case Zoladex. Not the same circumstances as you. In July 2018 I was diagnosed with Stage 4 Gleeson 8 PSA 152, in April this year after 9 months of Zoladex and 6 cycles of Docetaxel PSA my PSA is 0.07.

My MO recommends persevering with Zoladex alone until my PSA starts to climb. I’m not attracted to long term monotherapies for anything. But 9 months on Zoladex isn’t that long so at this stage I’m feeling if the horse is still winning why change?

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I’m scared right now to take a break . I too was #4 ,gl8 and I did Rt and double adt until

Orchiectomy almost two years ago . Still on test adt drug. Undetect for over 31/2 but I fear a rapid return if I stop adt .

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Lulu, My concern as well. Thank you!

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Do you want your PSA to rise?

GD

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I do not want my numbers going up, but taking a break is the only way for me to keep working. Work life balance?

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Take an easier road? Must be 20 times a year I mention the Vantas implant. This Implant contains a Lutenizing agent similar to Lupron. The implant is inserted into the inside upper arm in a Doctor's office--and takes about 5 minutes--and you get 3 stitches, and can take them out at home. Usually started with Casodex, but since you are on Lupron now--there will not be a need for the Casodex, unless you want to go to ADT-2, and or add Avodart and go to ADT-3.

The Vantas Implant puts out a daily dose, and is good for 2 years--one of my Docs. said he left it in a patient 5 years. You monitor with PSA and T tests. When T starts rising, you exchange the implant. Easy to take vacations, you just have it removed, and you have in 2 days zero Lutenizing agent on board.

As to kicking your ass---this Implant has the same side effects--but those that use it claim they are mild. When on it, I personally, use to get a touch of fatigue at about 2 PM which can be overcome with coffee, taking Ginseng, a small nap, or going to the gym. Gym worked for me.

The male menopausal side effects are very minimal--some describe having a small wave of heat when going to bed lasting about 3 minutes.

We call it Steady Eddie---as the level of drug does not change and there are no highs and lows, that you get with the shots. Your body gets acclimated to it, and the minor side effects for many become unnoticeable.

Many younger docs. do not know of it. And those that do will make less money for a one time procedure, instead of a chorus of shots, over time--and then Boo Hoo it.

If you want it you may have to fight for it--in my community--it is standard fare, between 2 MO's and 1 Urologist. Google it and read up on it. This may be a way to go for you---I am just reporting.

Nalakrats

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Thanks! I will discuss with my oncologist. Glad there is options. I have decided that I need to stay on treatments so my numbers stay low.

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Not sure what you should do, but wow...did you say 38 rounds of radiation? In what area?

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To try and answer your question. 38 rounds of rad sounds like the prostate bed after RPD. Sorry If i'm not correct... but I'm a butinsky...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/14/2019 5:22 PM DST

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The prostate bed, they thought it was what was producing the PSA, but my numbers didn’t drop until Lupron was in my system for 5 months. Since then The auximen scan showed a large lymph node in my groin that was in the area radiated. Hopefully the chemo worked. I will stick with the Lupron But I hate the way it makes me feel. Oh well, it does work for now. 😊💪

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2 years of Lupron injections were recommended by my doctor for the purpose of lessening the chances that cancer cells could return in the next 5 years after I had completed prostate removal surgery and 38 radiation sessions, getting my PSA down to .01.

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Did you have RT to all pelvic lymph nodes? Like you I took holidays from adt after 13 months but Psa doubled in two months every time. No more holidays. See profile. Now I’m on estradiol patches . No more Lupron . The patches work the same with fewer side effects. Google PATCH trial for info.

Bob

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He did take several lymph nodes but they were negative. The seminal vesicles were positive. I am going to ask about the patches. Thank you.

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My nodes were negative too but two years later PCa showed up there so I had them zapped. I was stage pt3b also. See my profile.

Been there done that!!

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I think i'm a lupron lifer. More power to those of you who can take a vacation. Maybe I'll be there someday. Enjoy.

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Thanks for the reply, I might very well be a lifer as well, another vacation might be a poor choice. I knew the feedback on this site would help me decide. Thanks!!!

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I hope the fda approves the patches after the patch trial is over so Lupron makers go bankrupt! The stuff is a man killer!!!

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I started with 42 radiations in 2007 and they found metastases in 2011. I had 30 more radiations and started Lupron (3 month shots) later changed to Eligard (generic). I stayed on Lupron for 6 1/2 years and now I have no cancer. I found that after the first year the side effects of Lupron were not as bad. I wish you luck in your decisions and above everything else just keep truckin'.

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That is great! You obviously never became hormone resistant? Are you now treatment free?

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I never became hormone resistant, my PSA was 0.006 for 5 1/2 years. I am treatment free from cancer for 1 year now, but I have diabetes, heart diseases, and kidney stage 4 disease. I did not have radical prostatectomy (RP) and I can have orgasms (dry) but my T can come back with time, which would help. I am urinary incontinent, sleep with a CPAP mask and I am 74 years old now. I am selling my Condo and moving into a nursing home in July. I am amazed that I am still alive! My life is relatively normal and I have decided to eat a vegan diet, because of kidney and diabetes diseases. I go to a gay church here in Orlando and they really helped me get through cancer with support and prayers. I also go to 12-step programs and sponsor two men, which keeps me busy. I hope you understand that this disease has times when you have low energy, and other times when you feel just fine! Watch your lab reports for everything including B-12 or vitamin D 3 or Potassium. All of these can make you feel tired if the levels are off. My creatinin kept going up because of my kidney disease and that made my hemoglobin go down, which made me tired. But you can get your test results on your home computer and look at everything. Then ask lot of questions because the cancer doctor is interested in your cancer, not your entire body. So stay in charge of your recovery and just keep on truckin'.

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You are an inspiration thank you for your advice and message!

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I had the same situation after RP and 38 Radiation treatments except I had a met in a rib. I was getting a treatment plan of intermittent Lupron. I changed Drs and I have been on Zytiga and Lupron for 14 months. They did SBRT to the rib met. It was thought at one time I had mets in two lymph nodes and they were going to treat them the same way. The drugs are hard but my PSA and T have been undetectable for 8 months. My plan is two years.

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