Now starting ADT, any advice for the side effects?

[Odon]

I am 66 from Romania.

In 2014 RRP G3+4 PSA 5,17.

In 2017 PSA grew from undetectable slowly to 0.32, having SBRT.

Now again increasing to 0.62.

Today I am starting ADT Bicalutamid 150mg and Tamoxifen 10mg for 6 months.

Any advice for the side effects? To do something in advance to avoid some of them? I am in a healthy diet, not to much heavy exercise because my back problems, but I am doing some light gymnasthycs regularly.

Until now slight erectile problems but with Viagra it worked very well.

Thank you all.

[noahware]

The good news is, since you are not doing the standard ADT of Lupron, side effects may be minimal. I have been taking the same meds as you (plus finasteride) for about five weeks and have had no problems. (Perhaps a slight bit of fatigue and decrease in sexual interest, but I've experienced far worse in both departments during episodic periods of depression over the years.)

These meds are not depriving you of T, or of estrogen, but rather are blocking androgen receptor activity. Your serum T and E2 levels will actually rise, which is why you are taking the tamoxifen (it is a SERM, which selectively blocks the increased estrogen from giving you breast growth/pain).

One possible side effect of these meds is on liver enzymes, so your doc should be monitoring these in your next blood work (in a month or two). If you can do so without straining your back, try to add some weights or other resistance training to your exercise, to maintain muscle.

Just curious: why only six months, and what is the plan after that? Will you continue on a lower maintenance dose of 50 mg, or go off meds and see what happens?

[Odon in reply to noahware]

Thanks. We'll see after 6 months the results, maybe we will do the intermittent way. We don't know yet. what is for the Finasterid?

[noahware in reply to Odon]

The finasteride (Proscar) was added by my MO because some studies indicated that it worked better than bicalutimide alone. It is a 5α-reductase inhibitor, and works by decreasing the production of dihydrotestosterone (DHT) by about 70%. DHT is an androgen thought to promote PC.

I am also thinking of going the intermittent way, but planning at least a year on these drugs. Even though the PSA level itself drops very quickly, I have no idea how quickly cancer cells might be dying and being "put to sleep" (or whatever mechanism we might call it... dormancy, regression or remission?)

I am not saying 6 months is too short for a good enough benefit, but I almost feel like 12 months could be, too. Some will say, stay on it as long as it keeps working, even 5 or more years, but I feel like too long on any med gives the cancer a good chance to evolve and develop resistance (and perhaps not be as effectively treated, even with other meds). But this is just one school of thought.

[Magnus1964]

Has anyone mentioned radiation therapy. It might be a good next step in trying to eradicate the cancer. That said, casodex (Bicalutamide), is a good ADT drug to start with. It is milder with fewer side effects. The one side effect I had was hot flashes. They lessen with time. I got 5 good years with casodex. Here is hoping you have many year of quality life.

[Tall_Allen]

You had SBRT of what? The prostate bed? pelvic lymph nodes?

The tamoxifen is great for preventing gynecomastia. Exercise is important for maintaining bone mineral density and lean body mass. Manage the side effects as thay arrive. You'll probably find that your libido diminishes over time. Viagra depends on wanting sex.

[Hidden]

May the srbt work well and help you out . Some fellows don’t suffer much from adt . It amazes me because I got hit hard by adt .. with extended use adt will put us in osteopenia or worse if you don’t do some weight bearing exercise..this could be yoga or your gymnastics that you’re already doing . With adt we need to look out for bone and heart health . . . Peace to you in Romania Odon ..✌️

[Odon in reply to Hidden]

Thank you Whimpy.

[Hidden in reply to Odon]

Hang in there Odon.. !

[Hidden]

Was not Oden a god in fokelore . ?

[Hidden]

In Tucson Arizona as a kid in the 60’s we had a rowdy violent motorcycle club named “ the Sons of Oden “ they were Some bad dudes.... don’t know whatever happened to the guys? But I’m sure it didn’t end well for them maniacs. They chased my older thru the Desert once , didn’t catch him. Peace to Odon . I like that name .

[Odon in reply to Hidden]

My Odon name is a Hungarian name really it is Ődőn. The German equivalent is Edmond. I am a Hungarian guy living in Transilvania in Romania.

[Hidden in reply to Odon]

I had thought that Odon was a norsk god of old lore. Anyway brother. All beautiful places to be . Enjoy your life . Have a nice weekend and do anything to take you mind off of pc . 🌵😎 Scott in Prescott Arizona...✌️

[Bushido9 in reply to Hidden]

Odin is a Norse God of war, destruction. Oden is a Japanese food. Odon is a Hungarian name. Odan is a Russian rurality...

[j-o-h-n]

The Romanian description for ADT is Rahat....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/25/2020 7:21 PM DST

[Odon in reply to j-o-h-n]

HaHaHa. So, should I avoid it? (Pentru ca miroase urat).

[j-o-h-n]

There's not much to do before starting ADT..... Sorry......... (and it smells bad too)... I don't think you should avoid it but your life changes, that's for sure. -

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 06/26/2020 12:19 PM DST

[Odon]

Thank you, I appreciate your comment.