BCR after castration

[Shegolf]

Has any ones PSA gone on the rise after orchiectomy? I had Casodex for 25 days then a Lupron shot 7.5 then the next month Dec 18 the Dr switched to Eligard stating they changed vendors. The day I got the shot I could hardly walk. Called the Doc the next day he said it should work itself out. After 3 visits to the ER I was hospitalized for 2 months. A freak staph infection from the injection itself and every damn side effect you can possibly get I got. I got out of the hospital Feb 10 and had to have home health come in. My PSA went from 01 Feb 20 to 3.3 April 28. After speaking with urologist I will try Lupron, as I had no noticeable issues after 1 month. The problems came with Eligard. I am considering orchiectomy. I am 79 and had radiation 22 years ago. My PSA started to double and now it is really moving. Thoughts out there

[Tall_Allen]

The only downside is that you can't do intermittent ADT.

[Shegolf in reply to Tall_Allen]

Is that a down side really? I am 79, will be 80 in Aug. side effects in studies appear to be less. I tell you the Eligard almost did me in. Fortunately I had a one month shot . The Dr suggested a 3 month shot. I would still be recovering. In reading many post related to orchiectomy it appears overwhelming, that most do not miss their nuts. I have type 2 diabetes, have gone through an emergency heart bypass surgery and now recurring prostate cancer. Do I need a stroke or other heart issues?

[Tall_Allen in reply to Shegolf]

Most of the side effects of ADT are the same with orchiectomy because they are due to no testosterone. CV issues are similar (higher, lower, or the same depending on the study -- Firmagon may be better). GnRH agonists (like Lupron) get testosterone lower and may have fewer metabolic side effects:

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

onlinelibrary.wiley.com/doi...

Some men like the breaks they get with intermittent ADT. If you don't need those breaks, go for it.

[Shegolf in reply to Tall_Allen]

Thank you for your input. You are a regular on this site. Good luck to you!

[Gearhead]

What an awful ordeal. But I'm not clear: Are you confident that the reaction and ordeal was specific to Eligard nd/or it's subcutaneous injection, or are you concerned that the same thing may happen with a intramuscular injection of Lupron? If you're not concerned about Lupron, are you considering orchiectomy for simplicity or...?

[Shegolf in reply to Gearhead]

Yes considering Orchiectomy. The 2 Week cadodex and 1 month shot of lupron did not seem to bother me. But when I got that Eligard all hell broke lose.

[Shegolf in reply to Gearhead]

Not considering for simplicity. Considering Orchiectomy so I don’t get all chemical reactions. I am aware that there are similar side effects but after much research and speaking with a couple urologists it might be tight for me.

[GP24]

If you reduce the testosterone with orchiectomy you will become resistant after about 2.5 years just as if you took Lupron.

Maybe they will allow you to take Xtandi or Erleada without ADT then. This way you would not need to reduce your testosterone.

[Shegolf in reply to GP24]

At 79, 80 in August, I am seriously considering Orchiectomy. But I may try the Lupron again one month at a time. The difference between lupron and Eligard is the delivery system.

[Shegolf in reply to GP24]

Testosterone is cake for PC. Need to stop the T. One way or another. Many on this blog have gone Orchiectomy and do not seem to regret it. It is still a tough decision. I don’t want to Be scheduling doctor appointments the rest of my life. Need to golf! 😊

[GP24 in reply to Shegolf]

"Has any ones PSA gone on the rise after orchiectomy"

You will become resistant after 2.5 years just as if you would take Lupron.

"Considering Orchiectomy so I don’t get all chemical reactions."

There are no chemical reactions by Lupron, the side effects are all caused by the missing testosterone.

"I don’t want to Be scheduling doctor appointments the rest of my life."

This is the fate of PCa patients, even with orchiectomy.

GnRH agonists for prostate cancer are mainly leuprolide, goserelin and triptorelin. Lupron and Eligard both use leuprolide. You may ask your urologist to use a goserelin or triptorelin brand next time. Or, if you do not mind a monthly shot, Degarelix/Firmagon.

[V-Man in reply to Shegolf]

Golf!! I feel the same way

[Rob1053]

I too had a bad experience with Eligard. I have had Lupron before and after and had some terrible stiffness, worse depression and lethargy with Eligard. I convinced my insurance carrier to go back to Lupron on next shot. I take the 3 month shot and an on intermittent therapy. Everyone said it was the same but it was not for me. Have been fighting this for 15 years and let my PSA get to around 100 before taking shot. To me quality of life means more that longevity. Good luck.

[Magnus1964]

That is a really bad experience. Do you still have confidence in your medical providers? Switching you from one drug to another because they changed companies doesn't inspire me.

[Shegolf in reply to Magnus1964]

No and it did not inspire me either. The doctor said it is the same as lupron just a different name. Both deliver luprolide. What ever you call it.