Saw my Oncologist on the 1st Nov, PSA has been 0.28 since I finished Chemo in May (originally 1386). I'm on Diphereline (ADT) for 12 months now and he just started giving me Casodex.
I just wondered why he did this if everything is stable, any ideas?
The cancer is still there and must be treated systemically. You had a good response to chemo, so the thinking is that another strong systemic therapy can help lower the cancer load still further. Scans only show mets that are big enough to see. PSA is only a biomarker - it is correlated with the cancer load, but doesn't really tell you about the cancer that is not yet putting out PSA.
The recent ENZAMET trial showed that for first-line therapy, enzalutamide +ADT was superior to casodex+ADT, so you might want to ask your doctor for some stronger stuff than casodex. In the US, enzalutamide is not yet approved for this purpose, but it may be different in Australia. Now you are taking it as a second-line therapy while you are still hormone sensitive, which is a little different, but it's probably true as well.
Thanks
I'm in Estonia (EU) and not Auz, wish I was though, it's much warmer lol
I wish I were in Australia too, although the temperature in LA got up to 33°C yesterday.
That's 91.4 degrees Fahrenheit for those of you who were to lazy to google it.
Thanks
On my meeting 1st Nov the Oncologist also mentioned surgery, not a full Orchiectomy but just to cut the lines to prevent production of Testosterone. Hospital called me yesterday and wants to do surgery on 21st, wow that was fast.
With Gleason 9, PSA 1386 and Mets to every bone, including getting into the Marrow in Femurs and causing some neurological damage and pain, I guess they're trying to cover all bases.
I just thought nothing more would be done until they saw the PSA start to rise.
He's a young guy, seems smart and enthusiastic. I told him I trust his judgement.
I know they also review my case on a panel of Doctors and anything done to me is probably first suggested and agreed as a course of action by this panel.
Casodex is my life saver intermittently along with PCSPES. I use 50mg for 10 days every other month and it keeps my count stable for 3 years now.
How much is he giving you . The reason I ask is if it's 150mg. it's too much and tolerance develops quickly.
And their bank balances are in finer condition. With Medicare part D, your yearly fee for Casodex could be zero, with Xtandi and other such 2nd generation AR inhibitors, could be 14,000 annually. If no insurance and not qualifying for subsidies the sky could be the limit.
Casodex monotherapy worked extremely well for myself after failing ADT, chemo and Xtandi. Who knew?
I live in Europe, I'm not at the mercy of private insurance companies. The hospital facilities and Doctors are very good. The only bad thing I see is because it's such a small country (1.3m population) no medial trials are available.
Hi Zetabov
In Estonia (Tartu university) is clinical trial: Atorvastatin/placebo+hormone therapy.
Buy a bra..............
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 11/12/2019 7:14 PM EST
Was on Casodex for nearly 2 years after double orchiectomy (miss those guys much), Casodex worked well, PSA went down to 0.04 until I became resistant, then PSA crept up to 25, then to 100 in 5 months. Had radiation due to metastasis on the spine. Now on Xgeva monthly and Xytiga and Prednisone daily. Have yet to check my PSA. Good luck to you!
Casodex Trial
Casodex 
Adding Casodex
Casodex - stop or continue ?
Casodex 50mg
