ADT...Eligard vs. Degarelix?

[JPnSD]

I am meeting with my URO to discuss the details of starting ADT (after 2 months - SRT begins). She seems to be looking at Eligard or Degarelix. Any comments? Other preferences based on fewer side effects balanced with effectiveness?

[6357axbz]

Degaralix begins with two injections into your stomach fatty tissue. Then one injection/month.

Eligard is one injection, same place.

I think degaralix is only a one month dose. Eligard is available from one to six months dose.

[JPnSD in reply to 6357axbz]

Thank you.

Correct...So Eligard (generic of Lupron which is no longer manufactured)..comes in 1,3, 4 and 6 month doses. Degarelix is a monthly. I am leaning towards 1 month Eligard to start...then switching to 6 month after determining the side effects and if any serious side effects.

My major concerns are the long term side effects....since looking at 2-3 years of treatment.

[MateoBeach in reply to JPnSD]

Both work well and Eligard is more convenient. Firmagon has the safety advantage. Injection site reactions are personal and not predictable. I had a terrible reaction to Eligard and none from Firmagon, personally. And Firmagon actually kept me castrate for 3 months from a single injection despite the standard monthly schedule.

If it is side-effects that concern you consider adding topical estradiol gel or patch to either. So much nicer! Good luck.

[JPnSD in reply to MateoBeach]

Thanks. Which of the side effects does the Estradiol address? Any side effects from Estradiol itself?

[MateoBeach in reply to JPnSD]

Estradiol topical patches or gel when added to ADT such as Eligard or Firmagon stops all of the hot flushes. It improves the cognitive brain fog substantially. Feel more energetic and less apathetic. It also improves bone mineral density loss from ADT. It has not been shown to increase cardiovascular risk when used topically (vs orally which does increase risk as does DES). Main side effect is breast tenderness and gynecomastia. This can be blocked by also taking tamoxifen at 10 mg daily. I felt much better with estradiol added to ADT as have many here. Search PATCH trial on this forum and elsewhere for information to support discussing it with your MO.

[JPnSD in reply to MateoBeach]

Many thanks for the info.

[V10fanatic in reply to JPnSD]

When was Lupron removed from the market? The FDA shows the 1 month shot being available.

[Tall_Allen]

Eligard is more convenient. Firmagon works faster and has fewer cardio side effects. Injection site reactions are worse with Firmagon.

[JPnSD in reply to Tall_Allen]

Thanks...The URO just left me a voicemail indicating her preference for Degarelix/Firmagon...so looks like that is the route we will be taking.

[binati in reply to JPnSD]

I've been on Firmagon since Jun 19 which is around 15 months. The only problem is the monthly injection. As regards the injection site inflammation, fever and pain etc I have realized after some help from the doctors injecting the Firmagon that it must be injected into the flesh. If you have a muscular stomach then get injected more towards the side of the body and a little above the navel where you will not have your trouser waistband. Each time it has been into the flesh there has been only some redness and slight discomfort for 2 days max. Last time I played golf two days after the injection.

[CSHobie]

I have been on monthly Eligard now for about 7 months, it is working for me.

This is something I found, about the 1 vs 3 months versions.

oncolink.org/oncolink-libra...

I can't comment on the other drugs, but I agree with you, get the monthly version , at least for a start

[NevsMates]

I have been on Eligard since April 2011. Injection every 28 days by choice. PSA was doubling every 90 days for almost 2 years after radical prostatectomy before commencing.

PSA still undectable. Age today 74.

Hot flashes are not a big deal for me, so I am lucky in that regard. Can sting a little bit during the injection sometimes.

Genitalia shrinkage can be an issue after a few years. Best wishes

[Stevana]

Have been on Firmagon for six months. PSA has steadily dropped from 7.8 to 0.23. Main side effects are hot flashes, minor fatigue and loss of libido. Hot flashes have subsided but have not completed disappeared. I fight fatigue by staying active with moderate exercise and yard work. Libido is still nil, but plan to work with my urologist for a potential remedy.

One thing I’ve learned after my six Firmagon injections in the stomach ...if you instruct your nurse to administer the shot at a 45 degree angle and to push the injection in slowly, over a 60 second period, it will remarkably minimize the soreness afterwards. After my first shot, which was a jab and squirt, I could barely bend at the waist for 5-7 days. With this new method I have only the slightest tenderness for about a day or two. This small effort has helped me tremendously. Of course you need rotate your shot on either side of the stomach each month.

Don't know if chemotherapy is in your future but I’m at the mid point of my six-cycle docetaxel treatment. I seem to be handling it pretty well with side effects of thrush and heavier fatigue for about seven days after. I use nystatin for thrush and it eventually clears it up, so far. I do fast the day before thru the day after chemo and it seems to help me tolerate it well in addition to making the drug more effective, so they say. Also, ice therapy has helped me keep neuropathy of hands and feet at bay so far. I used a polar cap but lost my head hair anyway.

Good luck. Hopes this helps for future reference. Stay strong 💪💪💪✌️✌️

[JPnSD]

Thank you. When you say 45-degree angle are you talking about a 45-degree angle to the surface of the skin? Or a 45-degree angle relative to waistline (verses parallel to waistline and 90 degrees to spine?)...and closer to skin surface?

I will pass on the 60 second injection advice. Thanks.

[binati in reply to JPnSD]

The flesh is pulled up at the side of the stomach and held in two fingers and the injection needle is inserted at 45 deg angle to the stomach. Inject slowly eg. 30 secs and hold the needle inside for another 30 secs and withdraw slowly. Important to make sure it is not injected into the muscle as that is when it is really painful and can give rise to fever for 3-4 days.