Hello, would like to get some feedback on switching from Firmagon to Lupron.
Have been on firmagon and Erleada since 8/19. I have tolerated treatment well to this point. MO wants to start lupron this month. Kind of concerned about switching to a new med when the existing one is being tolerated fairly well.
Have read that firmagon can be less a impactful on the cardiac side of things. Looking for some input on this.
Thanks
It's probably a good idea to get a 6-month shot of Lupron until the pandemic is over.
That's just what I did after getting 3 month shots for 5 continuous years. I postponed my next shot for 4 weeks at my doctors urging (I'm on Zytiga) and went in and received a 6 month shot of Eligard. Now I'm trying to decide if I should postpone my Zometa infusion due June 18th.
How bad is your osteoporosis?
1. Normal bone mineral density of the spine with T-score -1.0 SD.
2. Osteopenic bone mineral density of the right hip with T-score
of -1.5 SD.
3. Osteopenic bone mineral density of the left hip with T-score
of -1.4 SD.
Do you see any harm in postponing my Eligard for 4 weeks?
I kind of, sort of put faith in the following:
ascopost.com/issues/june-25...
You mean your Zometa shot? (you already got your 6-month Eligard shot). Those aren't seriously low BMD levels.
I don't know what other treatments you have gone through. I guess my first question would be why do you want to switch? Has your doctor recommended this change? Is your PSA rising?
If the firmagon and Erleada are working for you I would stick with them. I can't see abandoning a treatment that works. Mike it for all its worth.
I don't have any experience with Firmagon nor Erleada, and my Lupron is experience is limited. I was on Lupron for 6 months back in 2011-12 when I also got follow-up radiation treatment following a prostatectomy in August 2011 that had cancer in my seminal vesicles and in the margins of the removed prostate.
After PSA started becoming measureable in 2017 and up to 2.8 with 9 month doubling time, my oncologist and I decided to start casodex plus Lupron a few weeks ago.
In 2011-12 I had hot flashes, erectile disfunction and some loss of libido. This time around so far I haven't experienced those side effects that most men do. I suspect they may kick in at any time.
If Firmagon and Erleada are working for you with minimal side effects, why does your physician want you to change?
"In 2011-12 I had hot flashes, erectile disfunction and some loss of libido. This time around so far I haven't experienced those side effects that most men do. I suspect they may kick in at any time."
You can expect the side-effects to make themselves known with your next shot. The 1st shot doesn't usually produce significant SE's - but expect the kicker to show up with the next shot you get.
I spotted an interesting paper - actually 2 of them - last night:
Management of complications of androgen deprivation therapy
in the older man ncbi.nlm.nih.gov/pmc/articl...
This paper reviews all the more common side-effects of ADT - and then considers how to manage or avoid the bad side effects - particularly as related to patient age. Interesting stuff - a good primer onf ADT side-effects.
And:
Staging the Aging” When Considering Androgen
Deprivation Therapy for Older Men With
Prostate Cancer - an editorial in the Journal of Clinical Oncology.
ascopubs.org/doi/10.1200/JC...
The opening line of the above editorial says: It is becoming increasingly clear that androgen deprivation therapy (ADT) is overused in treating prostate cancer.
It discusses that ADT overuse is perhaps causing a reduced lifespan combined with a poor Quality of Life (QOL) when ADT is overused. It also questions if the studies on ADT are overstating the life extension offered by ADT (where death by PCa is considered) since overall mortality shows that cases of cardio-vascular and diabetic deaths aren't addressed in the ADT mortality - even though they were caused by the ADT treatment.
Sort of - we're not letting the PCa kill you because we're killing you first with side-effects from the treatment for the PCa.
A quick and easy read - about 1.5 pages.
Hi Silver5,
Do you have any side effects from the 2011 radiation. I have a similar path facing me. Not sure how long of ADT i'm willing to sign up for. 3 months? 6 months or none
I'm wasn't aware of radiation side effects in 2012, nor am I now -- but clearly one direct effect is that I'm not a candidate for more radiation to my prostate bed, where an Axumin PET Scan last summer suggested there was a small metastasis.
My urological oncologist says the current research seems to suggest that doing Lupron for 12 to 13 months before going off it is optimal. My initial depot was for 4 months, and I'm having my PSA tested every month. So we'll see over the next few months.
I have been on Lupron for close to eight years and I am very satisfied. It has been effective with moderate to mild side effects. I wouldn’t be concerned about the switch. I should add that I am not yet resistant.
Several months ago my MO
Switched me from 3 month Lupron injections( 7 year history with 3 year history of Bicalutamide) to Firmagon for 4 months hoping to reduce peripheral neuropathy and when neuropathy worsened I opted to switch back to Lupron without any change in PSA , remaining undetectable. I didn’t tolerate the Firmagon subcutaneous injections well at all . I would certainly want to know the reason why your MO wants to change regimes if not related to the pandemic .
Was on Firmagon for 2 years, it did start failing after 18 months. Went on Lupron (Eligard) right after that. It is much better to take as the abdomen shot ever 28 days was annoying and bothersome most times. Burning and itching. Happier with the Lupron injections now about 22 months. Was getting one ever 4 months how ever due to the Covid-19 now had one for 6 months program. The injection is much more comfortable. I have cardiac issues and Firmagon was the better choice at the time, The lupron did not effect my heart in any way. My cardiologist keeps me up to date with testing etc. Well pleased. The only thing different now is in addition I take Zytiga 4x250m daily and 5m of Prednisone daily. Had to do this as my PSA was starting to rise when the firmagon failed me. Now my PSA is coming in at 0.18 which is much better. I am stage 4 advanced Pca. Have many bone mets. in Spinal column, and Ribs as well as Let Hip Illiac after the Firmagon failure. Did more radiation on Hip to rid the pain. Effected my bone marrow in that hip. In spite of it all, I am doing ok so far. I was originally being treated at a Cancer Center from my local Hospital. after the Firmagon failure at 24 months, I decided to go to Fox Chase Cancer Center Phila. Longer drive but they have done wonders for me. My cancer is very aggressive, it gets crazy every so often, they keep attacking it to help me. I'm very grateful for my Research Team at Fox Chase. Highly recommend them if it is in a distance available to a patient. Wishing you the best. The change from Firmagon you will most likely see and feel the difference in treatment instantly. Unless you did not have any discomfort from firmagon injections.
Thanks for the reply, and the best of luck to you
Chemo as first treatment
What are the pros and cons of intermittent vs. continuous ADT?
