I started ADT + Casodex in November 2018 for my metastatic PCa in many pelvic and abdominal lymph nodes. Previously, I had Firmagon (three months) and two 3 month Lupron shots in 2016-2017 for extra-capsular- extension. In 2016, after the first Firmagon shot I had severe hot flushes, which gradually became manageable during the next two Firmagon and six months of Lupron.
This time, after the first Lupron shot in November 2018, I had strong hot flushes that settled down gradually. But after the third shot, the hot flushes became stronger towards the end of three months. I had the fourth shot on September 9. Suddenly, my hot flushes became very intense and I am having more than ten flushes a day.
My PSA before the first Lupron shot was 4.48. It went down to 0.17 in March, 0.1 in June, and 0.07 in September. By now, I may have reached PSA nadir and I am expected to stay there as long as ADT + Casodex works.
My question is why my hot flushes have become stronger after nine months. Does it have any significance regarding effectiveness of the treatment? I would like to hear similar experience from others. Particularly, those who became castrate resistant.