Bicalutamide not working any more!

[Jurasuje]

Hi Everyone,

I would like some advice/opinion of next step for me.

My PSA has gone from 0,45 to 0,54 to 0,73 with an interval of 3 months each time and when you calculate the doubling time is going from 12 month to 6 month, so very soon my PSA will be sky high, if my double time also increase, What would be the next step in my treatment (today i get only 150mg Bicalutamide every day).

History: Advanced prostate cancer: Removed prostate and 25 lymph notes in 2018 (gleason 9), but PSA was still rising after the operation and got on bicalutamide, which now has stoped working.

[LearnAll]

I second Nalakrats approach.

Drop the bicalutamide dose to 50 mg/day and monitor PSA closely. you might get pleasant surprise that your PSA is falling down due to what is called "bicalutamide withdrawal response. Enjoy that as long as it lasts and then, may be add lupron later on.

[Jurasuje in reply to LearnAll]

Thanks for the reply

[Magnus1964]

It may be time for radiation therapy. Consult a RT physician.

[Jurasuje in reply to Magnus1964]

Thanks for the reply

[Tall_Allen]

(1) Stop Casodex completely - stopping it may make your PSA go down

(2) Get an Axumin or a PSMA PET/CT - whichever is available in your country

(3) If the cancer is in the prostate bed or the pelvic lymph nodes only, get salvage radiation.

(4) Ask for a medicine that chemically prevents all testosterone from being produced (e.g., Zoladex, Luprin, etc.)

(5) If the cancer has metastasized to a more distant location, get docetaxel or abiraterone.

[Jurasuje in reply to Tall_Allen]

Thanks for the feedback really appreciate it, I will talk to my Doctor!

[Victorq1 in reply to Tall_Allen]

I WAS ON CASODEX (BICALUTAMIDE) AND LUPRON FOR ABOUT 10 YEAR

AND PSA WAS CONTROLED.

THAN

MY ONCOLOGIST DECIDED TO REMOVE ME FROM CASODEX

(TO MUCH INFLUENCE FROM PHARMA INDUSTRY ???)

AND CHANGED ME TO ANANDRON / NILUTAMIDE)

WHICH STARTED AN ALMOST DEADLY "CHEMICAL " PNEUMONIA.

THE JOKE WAS THAT I WAS TRAVELING IN THE COUNTRY WHERE ANANDRON IS NOT AVAILABLE

--TOO EXPENSIVE ??

AND ALTHOUGH I REPORTED MY MEDICINE

TO ABOUT 8 MEDICAL DOCTORS --

FROM DENTIST TO THE CHIEF OF EMERGENCY IN A HOSPITAL

NOBODY WAS ABLE TO DIAGNOSE ME .

THE DOCTORS WERE "LAZY"

AND IRRESPONSIBLE TO CONSULT EVEN THEIR SMARTPHONE ON THAT MEDICINE... AND I WAS TOO SICK TO DO IT MYSELF.

I AM PROFESSIONAL CHEMIST AND WITH ONE OF MY COLLEAGUES

IN GERMANY WE WERE FINALLY ABLE TO "AUTO DIAGNOSE" ME.

THAT CHEMICAL PNEUMONITIS IS SELF CORRECTING IF YOU TAKE CORTICOSTEROIDS (EG PREDNISONE)

WHICH I DID--

And was dancing again in 14 days instead of dying

on oxygen for a month and a |half.

So please stay away from this poison.

I REPORTED MY CASE TO FDA

AND CANADIAN DRUG AUTHORITY.

AND ALSO DESCRIBED IT ON FORUMS.

THOSE WHO ALREADY KNOW

PARDON ME.

THERE ARE ARE MANY WHO DO NOT KNOW.

HOW MANY OTHER DANGEROUS MEDICINES

ARE WE SURROUNDED WITH??

not funny THIS ONE j-o-h-n

[Jurasuje]

Yes i am living in europe and I will talk with my doctor about Lupron! Thanks

[j-o-h-n]

Where in Europe?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/20/20202 10:23 PM DST

[Notsdr]

I am curious if you decided to stop the bicalutamide without adding any other treatment, what happened to your PSA level? I have tried to make sense of the bicalutamide "withdrawal syndrome" and concluded it is only applicable if the patient is also on a standard agonist or antagonist therapy (e.g. lupron plus bicalutamide or firmagon plus bicalutamide). My theory is as the bicalutamide becomes less effective (e.g., androgen receptor resistance or it acts as a fuel due to mutation), when it is stopped, the lupron becomes more effective (and/or it is not fighting the effects of the rogue bicalutamide) and PSA falls. This is only temporary because at some point it is likely lupron will start to fail too and/or the lupron has its own limits of effectiveness. So there can't be "withdrawal syndrome" on bicalutamide monotherapy. My guess is if you stopped bicalutamide monotherapy when PSADT is shortening , PSA will always rise, not fall. So, what happened in your case? Thanks.

Richard