Firmagon vs. Lupron?

[Stevana]

My doc wants me to switch from Firmagon to Lupron so that’ll be on a 3 month schedule instead of the every 30 day shot with Firmagon. Which is the better of these two drugs? I started with Firmagon bases on its supposed lower risk for CVD. Not sure what to do. It would be nice to stop getting stuck in the belly every 30 days. But not sure how I’ll do on Lupron.

[Tall_Allen]

Because of covid-19, many doctors are suggesting 6-month Lupron shots. Firmagon has lower cardiac risk, so if you have cardiac problems, you may want to return to it after.

[Hidden]

I think it’s the typical move from Firmagon to Lupron . That’s what my specialist had me do. Definitely better than getting shot Up monthly . Also I believe that it is much cheaper than firmagon. I think thats one main reason it’s given ..I had one firmagon shot ,then a year and a half of Lupron shots . I was told adt shots life. So I chopped the boys in 2017. No mo shots. But I’m still on a pill adt to stop adrenal production of t.

[Stevana in reply to Hidden]

My doc is telling me I’ll be on ADT for life. I don’t like the idea of that. How were you able to get off it and go to pills? Do you still have same side effects. As far as treatment for my aPca , I’ve had three Firmagon, that’s it, and my PSA is now .078 and T is <3. I’ll be starting docetaxel next month. I’m hoping after that I can take a vacation from ADT.

[Hidden in reply to Stevana]

I was told the same . I’ve been on tak-700 a now defunct adt test drug that had failed for most . I started it with Lupron . I dropped the Lupron with an orchiectomy 9-17 . But I’m still on this pill form . I do still have many of the same side effects . I’m still on adt . My t is the same as yours for over four years. I think that you just might be able to take a adt break if things go well? Build up immunity with oxygen and good stuff.... since I’m on this test drug program my doc doesnt want yo rock the old boat . I’d love a vacation and to feel t again. But It will require me injecting t . If I have a windfall in the future Maybe I’ll Pursue It ? it might be costly.

[Stevana in reply to Hidden]

Sounds like you’ve been on a wild ride. My journey's just beginning. That’s why guys like you and others are so helpful. Sorta like paying it forward. I hope I’m around long enough to share some wisdom. Hang in there. Send more action shots. They are inspiring! Thanks.

[Hidden in reply to Stevana]

It was like the “Mad Hatter”

Wild ride for a bit. Ive gone through a wide variety of emotions , some probably never seen before. Some hopefully never seen again ? The beginning was the hardest ... you must jumps these first hurdles then recover from it . It take time to recover. I was hit hard with fatigue syndrome for two years. Still , the lasting effects of imrt and the constant use of adt leaving me with no t has it own effects.. Basically for me no stamina or real strength . You will do better than I did . I went into osteo . You I don’t want that or a heart attack..so you want to get cardio and strength training now and forever . Imrt at first appears to be nothing. If it like when I did it ? you sit with a group of guys waiting for a half hour. Then they put music on then you’re under the ray for less than 2 minutes. You pop up and get dressed drive home and you feel nothing the first few times. As time marched on fatigue hit me hard . I went from 233 to 165 and gaunt. That was because I fasted two five hundred calorie days per week of imrt . It’s called fast and live on YouTube.. also I cut all Sugar , animal proteins and processed foods. Theory is that in those two days of fasting that the bad cells will be weakened and eliminated more easily . It worked for me . I’m back at 195 and ok. Stay in touch please. Later .. scott

[Stevana in reply to Hidden]

Thank you for the tip on fasting. I’ve been researching this research doc, Dominic D’Agostino at Univ of S. Fla. He's all about using the keto diet to shut down glucose that feeds cancer tumors. So far he’s done it with mice in the lab but is looking into doing trails on cancer patients using a drug that puts you into ketosis. They've proven thus far that cancer cells cannot live on ketones which is what your body lives on when you deprive it of carbs and the glucose carbs convert to. Sounds logical but who knows. I was going to start the diet today and was doing well until I drank a bottle of red wine with dinner. Now I have to start all over again tomorrow. This is the life a Pca patient in these times of Covid-19. Which will get you first the cancer, the virus or the boredom?

He's the link if you’re interested: youtu.be/_blupWpZ5F4(Not working as expected?)

[Hidden in reply to Stevana]

Thanks, naturalpathics think sugar feeds cancer . I do too. It’s a bone of contention on HU. You’ve got many crazy weird adjustments to do all at the same time now with covid. Why not try dietary remedies ? “Food is medicine“ All you need to do during your 8 weeks. Sleep eat rest repeat .. exercise whenever possible. Pray that it’s healing you ? C hates oxygen .. Try to drink Mucha Agua Fresca . Towards the end of my weeks I got a freaking hemorrhoid the size of Texas . Never had one prior or since. I could Not sit down . My nat doc got me a nat suppository, that worked in just three days . Hope is you won’t get that either. Imrt is powerful stuff . This is one price that we pay to attempt to put pc away . It helped to kick mine down .. over four years now..It can help you too. If your ever going to go on a health kick? Now would be the time. You’ve got this . Always believe and do everything that you can to help heal yourself. Don’t listen to negative folks . Treatments tear us down. Stay strong and active .

[hansjd]

My husband had pretty much the same diagnosis as you two years ago, late Feb 18. He's been on Firmagon most of the time since. There was a period when his previous MO switched him to an agonist (Diphereline), but given the results of various trials, we weren't happy with the switch and changed back. It's our belief that Firmagon controls APC better than an agonist.

It's up to you, of course, but before making your decision, I suggest having a read of the following :

ncbi.nlm.nih.gov/pmc/articl...

pubmed.ncbi.nlm.nih.gov/246...

There are other similar references online, if you do a Google search. All the best.

[Tonyliv]

I too was cautious about switching to a three monthly shot, but it was the best move I made.

Firmagon every four weeks left me sore, but it’s the psychological benefits that are best. You don’t feel as much of a slave to the disease and have a better quality of life.

[leo2634]

I'm on Eligard six month injection. The needle is bigger but it's who administered it that makes the difference. My Doctor and his staff know exactly how to give the shot so that it is hardly noticed pain wise. The main reason I like it is that you have the freedom from a monthly injection and it is cost efficient. The side effects of all these medications are basically the same quality of life is greatly compromised but the key word is "Life" you learn to live and adapt to your new normal. I chose to eat and drink whatever I want to in moderation. I figured if I have to live with this why not enjoy the rest of my life. Never give up never surrender. Leo

[No17 in reply to leo2634]

We are both on the same regimen - Eligard 6 months shot-. I had my first mid March. I agree with you

Intuitively, I would rather do it at that Interval .And yes better have qualified and experienced personnel to administer it....

[Horse12888 in reply to No17]

I was pleasantly surprised that the Eligard injection was almost completely painless.

[FenBenGolf]

I received a double shot of firmagon at the onset of treatment (included 6 chemo sessions of docataxel at 3 week intervals) and was then on the every 3 month regiment of Lupron after completing chemo. PSA started to rise after close to two years. Added abiraterone acetate (Zytiga) and PSA has been undetectable for going on 10 months. Oncologist said that should be good for a year or so.

[Stevana]

Thanks to all for your responses. Sharing your experiences and insight helps us all in this journey. Mine’s just beginning but it’s nice to know I can get inspiration from those who’ve been there and done that, so to speak. “Stay strong” is more than just a phrase. It really has tremendous meaning when coming from guys like you. Thank you all again.

[MateoBeach]

Agree the evidence shows Firmagon works a bit better than Lupron and similar agonist drugs. I found for myself that a single 120 mg shot lasted me three months with a castrate level of T (11 at end of 3 months). With this I also used an estradiol patch 0.10/24 hrs changed out every 2 days. Felt very good on this regimen unlike on Lupron to which I am “allergic”. If you try it you must monitor T levels especially the first cycle to see how long it is actually effective for you.

[Stevana in reply to MateoBeach]

Thanks M. I’m hoping I can do the same regimen as you. In April I had my initial double dose of Firmagon (two 120 mg shots in the abdomen). In May and June I received an 80 mg shot. After my shot last week labs results show PSA at .078 and T at <3. I’m hoping this indicates that I'm sensitive to Firmagon in the sense that I react favorably to it’s intended effect and then may be able to take larger dose that lasts longer than the normal 30 day dose. It would sure be nice to get on a 90 day routine as opposed to the discomfort of every 30 days.

[MateoBeach in reply to Stevana]

Just because Firmagon was tested and approved as a monthly injection does not mean it does not last considerably longer. You could just follow T levels every two weeks and see how long it actually works to keep you castrate. I’d suggest a 120 mg dose. Worked for me. I go to Mexico for up to three months at a time so this will be my strategy since I do not tolerate Lupron.

[Stevana in reply to MateoBeach]

One last question - I’m getting treated at a university cancer center. I doubt they’ll agree to check my T every two weeks, although I’ll ask. I hear others on different forums saying they’re checking their T regularly. Our you going to Quest labs (the major one in my area) and paying for it yourself or is there a better alternative? Thanks.

[MateoBeach in reply to Stevana]

Medicare pays for whatever testing he orders and he orders it in agreement with my proposed plan as long as there is good reasoning behind it.

[Hidden in reply to MateoBeach]

What was the difference between firmagon and lupron side effects for you? Did you already take estrogen patches with lupron?

[MateoBeach in reply to Hidden]

I had very bad side effects from Lupron plus a local reaction at injection site. So I lost it as a medical allergy so it is off the table. I was not on estradiol then. Firmagon has minimal side effects for me probably because I also use estradiol with it which helps so much.

[EdinBmore]

Ask Tall Allen about the diff between the two drugs. My understanding is that, while they both reduce T, the way in which each drug works is different (agonist vs. antagonist). Anyhoo, Firmagon is monthly (no other option, methinks); Lupron/Eligard has 1, 3, 6 mos options. I opted for 3 mos cuz it gave me some sense of control (I can survive anything for 3 mos..so I told myself). I had bad reaction to both drugs; low T was devastating for me (but not true for all. Some guys are lucky and ask, "what's the big deal?" Yeah, well....

Good luck with your decision and ADT ride. Hope it's not forever for you.

EdinBaltimore

[j-o-h-n]

Lupron shot is a walk in the park......... not a shot in the dark........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/30/2020 2:36 PM DST

[Joes-dad]

For me I only did Firmagon until I was going to start my IGRT. Then I switched to 3 month Eligard shots. I did it to avoid monthly shots while also going to daily radiation treatments. I later switched to Lupron which for me was more comfortable.

Bob

[TJGuy]

So I'm on two years of ADT just beginning month 12 tomorrow.

I receive treatment at three different hospitals in three different states. Due to where I spend my winters, my summers, as well as where my primary hospital driving my care is located.

I began on three month Lupron injections. That I've received at two of the hospitals. Then due to Covid 19 I received a three month injection of Eligard at the third hospital.

So now driven somewhat by Covid 19 and travel concerns. It has been suggested I switch to six month injections for my final year, of Lupron or Eligard. And I was also given the option of a one year Vantas implant for my upcoming Aug injection. I will go off ADT to see my response to IMRT PBLN radiation I had in Oct/Nov/Dec 2019.

From a practical point of view I asked for what the cost would be for Vantas but haven't received a response yet. Believe that bill might include visit and incision to implant, the drug itself, and visit with incision to remove implant.

By the way this is what the three hospitals bill and get for 3 month Lupron from BCBS.

Hospital. A bill $15,000 get $1,400+

Hospital. B bill $15,000 get $1,300+

Hospital. C bill $20,000 to $25,000 get $5,000+

Not sure what six month would cost any experience in US by others?

My PSA was 0.032 at 5 1/2 months post IMRT PBLN radiation.

My T was 9.

So T and PSA are linked in this dance together.

What influences whether T does goes low or stays down to keep PSA down.

What breakdown of that process then makes T rise?

Now following through with the other portion if not half of the equation being lowering PSA.

Lowering T to castrate levels usually put PSA in check.

PSA control usually begins failing due to inability to maintain low T levels, or PC becomes castrate resistant.

Has there been any studies whether switching between various Testosterone suppressing drugs each time one is needed has any negative or beneficial effect on T suppression? Or time to castrate resistance?

I believe one of our members has written that he experiences rapid T recovery upon removal of his Vantas implant.

[judg69]

I had the initial double-dose firmagon shot followed by 5 more regular-dose firmagon shots. I was completing targeted IMRT at the same time. I don’t recall any really troublesome side effects from either treatment regimen. Best Wishes, judg69.

[tetech]

I like the Firmagon trial results for lower mortality rates and no T surge. If it hurts or wears off fast, the mfr can send a nurse to do the sterile mix and injection free and train your Dr.

If they hit a vein by mistake, they put another dose in subcutaneously (cost on them).

On avoiding covid, I wear my old N99 construction mask. Taking Statins, Melatonin, Metformin and Pepcid are all being tried against covid-19 and I take all of them.

Kaiser would not pay for Firmagon so I got the 3 month generic Lupron in the leg muscle; pretty pain-free. Lost as much as 7% of my bone density in 6 months, though so I am in the Osteopenia range.

[RonnyBaby]

Less frequency (shots vs. timeline) would at least suggest that I go months instead of weeks between treatments.

I had my shots every 3 months - would consider going to 6 month intervals in the future, just to spend LESS time dealing with the monster .....