Casodex vs Zytiga

[Geter]

Three years into diagnosis, mastasized into bone. Casodex controlled PSA first year. PSA went up a little, switched to Extandi, had Provenge treatment. Also shots of Eligard. Then Zytiga. Rising PSA now. Has anyone gone back to Casodex. Doctor suggest Taxotere next, but I'm not keen on it. Weight 120 lbs. 72 years old

[LearnAll]

Geter...Most doctors will not agree to go back on Casodex. Here is my honest opinion: You can go back on Casodex 150 mg a day along with Dutasteride 0.5 mg a day AND monitor your PSA and ALP every 2 weeks for next 2 months. If it works, stay on these two meds...If it does not work, you can always go for Taxotere chemo. I know, many members here may disagree and it will be difficult to convince doctor about this trial...it can be risky if PSA and ALP not monitored closely. Also, intensify your anti cancer diet and other complementary measures. .I know people who stayed OK with casodex for years. (its just an opinion..not a prescription) Good Luck.

Casodex May or May Not work.. Only time will tell.

[Geter in reply to LearnAll]

Thank you for your information and advice. You're right about an approval from the Doctor. He will likely not put me back on Casodex.

[LearnAll in reply to Geter]

Another option can be to go for Docetaxel chemo 6 rounds and knock the PSA down to very low level and then stay on Casodex afterwards.

[LearnAll]

You are right. Thats why I am only on 50 mg Bicalutamide with 0.5 mg Dutasteride for last 5 months.A strange thing happened after I started eating good amount of Boswellia powder and Cinnamon powder. My serum prolactin went down to almost half the previous level. Result of my silly experimentation. Dr Leslie Castello and his group (University of Maryland USA) think that high prolactin is responsible for androgen independent cancer cell growth. The same group which is publishing papers about Zinc chemotherapy.

[Bluebird11 in reply to LearnAll]

we just began Boswellia capsules... can you say how you take the Boswellia and the Cinnamon powder.. and about how much is eating a good amount...

Nice connection since I just found the Boswellia capsules as an addition a week ago.. I'd like to turn it into liquid..

[LearnAll in reply to Bluebird11]

Dr Leslie Castello's research about Zinc chemotherapy and connection of prolactin with growth of androgen independent cancer cells impressed me. He published a case report where he used on a patient ..ionic zinc plus clioquinol 3% skin cream plus Cabergoline (a prolactin lowering medication). This patient's advanced PCa

got "terminated" fully. Means he got cured. This is fascinating finding that prolactin promotes growth of androgen independent PCa cells.

I do not believe anti oxidant foods promote cancer...I have been on so many dietary anti oxidants/anti inflammatory for last 18 months and am doing well.

So I use Ionic Zinc (10 drops) with Clioquinol 3% cream on skin , Added Boswellia (a LOX inhibitor) , Celery Seeds and Ceylon Cinnamon (Cinnamandehyde) to my cocktail of anti inflammatory herbs and spices.

My plasma prolactin level was 14 ng/ml about 2 months ago, ....and last week.it came

back 3.9 ng/ml.

I bought Boswellia caps from Amazon..papnami brand. Clioquinol 3% skin cream is not available in USA . One can get it only from overseas ..like Mexico etc.

See study below:

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

[Herman_PSA_OK in reply to LearnAll]

Good Morning LearnAll,

"So I use Ionic Zinc (10 drops) with Clioquinol 3% cream on skin , Added Boswellia (a LOX inhibitor) , Celery Seeds and Ceylon Cinnamon (Cinnamaldehyde) to my cocktail of anti inflammatory herbs and spices."

For clarification (clearing my brain fog) looking at your above post and curious about the recipe for your anti-inflammatory herbs & spices. Sounds interesting to me.

So, you are taking the Ionic Zinc/10 drops/day in say your beverage AND separately also applying the 3% Clioquinol cream on your skin somewhere daily in order to enhance you Zinc levels/absorption to your body/prostate and perhaps lower your Prolactin? Yes/no?

Or literally are adding/mixing/combining the Ionic Zinc with the the 3% Clioquinol cream and then applying it to your skin? I'm assuming your Boswellia, Celery Seeds, Ceylon & Ceylon Cinnamon cocktail is part of your other supplements you take separately as well?

You said about yourself that, "My plasma prolactin level was 14 ng/ml about 2 months ago, ....and last week.it came

back 3.9 ng/ml."

I had never heard about the Prolactin possible connection before and started researching it. Great nugget of info. I did discover a long list of information among the Prostate Cancer Prevention at one site. Note! The material should be of interest to those with advance PCa like myself and you LearnAll.

lifeextension.com/protocols...

Near the middle of the info it does mention Prolactin and that the normal reference range for a Male was 4.0-15.2 ng/mL and the optimal for Prostate Cancer was <5 ng/mL. Thus, it looks like you are in the sweet spot according to Life Extension's medical research database.

I was going to ask you where /how you get tested for Prolactin. Do you get a script from your doctor covered by Medicare or insurance? The Life Extension test cost $55.00.

lifeextension.com/lab-testi...

At LabCorp (which I use often) anyone online can order tests online and then go to your local LabCorp for the blood drawing and get the results sent directly to you in about three/four days. You decide if you are going to share it with your doctor(s). This is not a promo and I'm no doctor.

In reading the Prolactin Blood Test instructions on their web site, what caught my eyes was: "Any type of contraceptives that contain hormones will invalidate hormone results. Drugs, supplements, and certain diseases may disrupt normal prolactin blood levels. These include hypothyroidism, antidepressants, estrogen, pain killers, diuretics, and arginine."

For me, my use of bio-identical Transdermal Estradiol (estrogen) would/may perhaps skew the Prolactin Test results. I guess and makes it of less value for me and I'm not about to totally stop the Estradiol.

So, my follow-up question is what bio-marker(s) are you looking at or hoping to impact? PSA or ALP?

You can either email me or post here if you wish to respond. It would be very helpful. Thanks!

[LearnAll in reply to Herman_PSA_OK]

My curiosity about role of plasma prolactin skyrocketed after reading a case report published by Dr Leslie Castello of University of Maryland. A top researcher in World about Zinc and Cancer. In this case report, when the prolactin level of this patient with mets was lowered to 1.9 ng/ml, his advanced Prostate cancer got cured, Dr Castello uses the term "got terminated".Then, I read hundreds of pages of Zinc and cancer related research in last 15 years.

I tried VITEX Chaste berry powder to lower prolactin with partial success only.

Once I used Boswellia capsules and Ionic Zinc with Clioquinol 3% skin cream...prolactin fell from 14 ng/ml to 3.9 mg/ml.

I take 10 drops (approx 25 mg) of Ionic Zinc in a cup of water and apply Clioquinol 3% skin cream in 3"X3" area of thigh.

Ionic Zinc is pushed by clioquinol inside prostate cancer cells and that results in explosion of cancer cells as diseased cells can not survive excessive zinc inside them.

I am Androgen sensitive but still use this to prevent becoming androgen independent cell growth.

Zinc therapy works for Androgen Independent PCa. Keeping plasma prolactin below 5 ng/ml is a good idea. It can lower PSA , ALP and CRP.

[Herman_PSA_OK in reply to LearnAll]

Grateful for your detailed Zinc supplement recipe!

[Purple-Bike in reply to LearnAll]

Hi LearnAll,

Is Clioquinol necessary for the absorption of the ionic zinc? Or can I just use some more ionic zinc for the less than perfect absorption without the Clioquinol? The claim is made that the the isoionic zinc that I bought is extremely efficient for absorption, with the tiny size of the particles making for much better absorption than e.g. tablets.

I ask because I find getting hold of Clioquinol is hard. Where I live I need a prescription and then I will get it together with Betamaston, or whatever the name was, with some strong medicinal purpose that I probably don´t want.

[LearnAll in reply to Purple-Bike]

Although Dr Leslie Castello's team used clioquinol 3% skin cream as Zinc Ionophore.Zinc ionophores are molecules which attach to Zinc Ions and take them inside prostate cancer cells. The theory is that once excessive zinc ions are inside the cancer cells, they can not tolerate it and burst and die. It is also claimed that normal healthy cells can tolerate high zinc inside them.

We need a Zinc Ionophore for Zinc therapy to be effective.

Some well known zinc ionophores are Quercetin and Resveratrol. Quercetin is plenty in Capers, Red Onions, Green and Black tea (EGCG), Red Apples etc.

Resveratrol is found in dark red Grapes, Peanuts, blueberries and other berries .

The amount of these natural zinc ionophores has to be high in diet to work as Zinc Ionophores. I am eagerly waiting for more research in area of Zinc Therapy.

[Purple-Bike in reply to LearnAll]

Thanks, LearnAll. Costello´s research results so far are indeed intriguing. However, almost four months after starting my monthly Firmagon injections and five months after diagnosis of GS-9, I took a test for my prolactin and it came to just 6.6 ng/ml, just a bit above that ideal threshold of 5. Could you give me your take on this - should I wait some months and make a new test? Or is the zinc therapy possibly killing cancer cells independent of prolactin level? I suppose I can find out by reading up but if you know this off-hand........

[LearnAll in reply to Purple-Bike]

My prolactin came 3.8. I have been on Zinc therapy. .initially to prevent severe Covid19 and later as per Dr Castello's protocol once I was able to get Clioquinol 3% cream. I see no harm in using Zinc therapy. I use many natural dietary products besides Bicalutamide 50 mg /day. Its not possible to know what is helping how much. But the big fact is for whatever is helping, I feel great and at present I do not even recognize that I even have PCa. Hope it stays the same for long time.

There is another simple way of reducing Prolactin. VITEX fruit capsules , available on Amazon..can knock down Prolactin in 2 to 3 months. I used this natural substance for 2 months in past. Zinc therapy alonh with Quercetin, EGCG and preferably Clioquinol 3% cream is supposed to kill cancer cells of all kinds ..There is a case report from Dr Castello which he published ...which says " A patients PCa was "terminated" after use of Zinc therapy.

[Purple-Bike in reply to LearnAll]

Thanks again! I will go for this combination and already have the zinc, but the only clioquinol I can find is 3% with Betamethasone 0.1 % which has a stronger anti-eczema effect than hydrocortison and is probably not good to have on my skin. Would it be OK for you to give me the link to the supplier you have in Mexico?

[Purple-Bike in reply to LearnAll]

Hi LearnAll, About how many grams/kilos do I need for say a three-year supply with a twice daily use?

I found a supplier of pure clioquinol 3% apparently without hydrocortisone or betamethasone, in Mexico. I have a friend there who I will ask to arrange a prescription and order and send it to me.

[LearnAll in reply to Purple-Bike]

Dr Castello in his research paper wrote that cream was applied to a 3 " X 3" area of skin daily.

[GP24]

Later studies report that Bicalutamide 150 mg is more effective than 50 mg in advanced patients with e.g. bone mets. So the guidelines mention 150 mg only. I think you can use 50 mg if you have a slowly rising PSA value after surgery and radiation. If you already had Chemo, I would use 150 mg. The side effects are not much different between 50 mg and 150 mg so you might as well use 150 mg which is more effective.

pubmed.ncbi.nlm.nih.gov/167...

pubmed.ncbi.nlm.nih.gov/856...

[LearnAll in reply to GP24]

GP24....If 50 mg Bicalutamide is keeping PSA at 0.3 and Alkaline Phosphatase at 49...(Bone ALP at 9.2) why there is need for 150 mg Bicalutamide ? What's the rationale ?

We always end up into this old discussion...Why do we need a machine Gun if the regular handgun is killing the bird ?

[GP24 in reply to GP24]

Geter wrote: "mastasized into bone". I am not sure if I would use Bicalutamide at all in that case, but not 50 mg. Of cause it may seem to work for you, but for how long? If you look at the graphs of the side effects in the Kolbenbag study I provided a link for, you see that the difference between the side effects is so small, no need to take chances.

[Magnus1964]

Generally, once you have failed a drug you can't go back on it. There has been some evidence that chemotherapy can resensitize the body to ADT drugs.

[Tall_Allen]

"Doctor suggest Taxotere next, but I'm not keen on it." Why is that? It's your single best therapy and it improves your quality of life.

[Geter in reply to Tall_Allen]

months of discomfort...

[Tall_Allen in reply to Geter]

But when it's done, you feel better than you felt before it started. It adds more to survival the earlier you use it, and side effects are worse the longer you wait.

[noahware]

The fact that PSA started to rise while on casodex is possible evidence not just that casodex was no longer working, but that it was actually feeding the PC growth and progression, since there is evidence that the mechanism can switch from AR antogonist to agonist. That is why it is usually suggested not to return to that drug after it fails: it not only may fail again, but may help the cancer to grow!

But that does not mean nobody has ever successfully returned to casodex... it just means, as LearnAll suggests, that you must monitor PSA very closely and frequently. A return to that drug MIGHT work. But in the USA, it would be very rare to find any MO that thought it was a good idea.

If and when Casodex fails for me, I expect to move on and never return. I will try high-dose transdermal estrogen, if I can find an MO to work with me on that approach (as studied in the current ongoing PATCH trial in the UK).

[LearnAll in reply to noahware]

Exactly. Casodex is anti androgen with lowest degree of side effects. Yes. Its an anti androgen lutamide ...just like newer Lutamides . It does become agonist at some point...But that some point in future may be 1 ,2 ,5 or even 10 years down the road.We have at least two members on this site..for one Casodex lasted 8 years and for other, it lasted 5 1/2 years. There may be more people which I do not know with such results.

We are not getting married to Casodex...If it stops working we will find something different.

I know you have heard about Casodex withdrawal syndrome...which means after stopping casodex , PSA can fall to very low levels and may stay there for a long time.

The longest case of casodex withdrawal syndrome was reported from Japan...That man's PSA remained undetectable for total 8 years after stopping Casodex . He was on Casodex for 4 years prior to stopping it.

If Casodex resistance sets in...My plan is to ADD Niclosamide to it. It makes Casodex work again. See the study below:

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

[MateoBeach in reply to LearnAll]

I was effectively managed for 4.5 years on bicalutamide 50 and dutasteride 1.0 before it turned on me. Had a Casodex withdrawal PSA drop on discontinuing. My PSADT seems to be much slower (longer) since than it was before. How would you obtain niclosamide in the USA? Trip to Mexico where it is OTC? Is there a veterinary form?

[LearnAll in reply to MateoBeach]

I do not know about vet form. I heard that it is available overseas but not in USA. Many research studies are using this combination in their clinical trials in USA.

[MateoBeach in reply to LearnAll]

Since I spend half the year in Mexico I will try to stockpile some when I am next there. Any idea if quercetin is an adequate Zinc ionophore in its absence?

[LearnAll in reply to MateoBeach]

Quercetin, EGCG , Black seed oil, Hydroxychloroquin are all zinc ionophores. For me the real drop in plasma prolactin happened only after applying Clioquinol 3% cream.Seems the natural ionophores are milder.

[MateoBeach in reply to LearnAll]

Actually I see that clioquinol 3% is available in the US combined with 0.5% hydrocortisone. Ala-Quin is one brand.

[LearnAll in reply to MateoBeach]

Mateobeach...Were you on Casodex monotherapy for 4 1/2 years...And were you metastatic that time ?

[MateoBeach in reply to LearnAll]

I was not metastatic on conventional imaging and combined the bicalutamide with dutasteride as an alternative ADT since I was very intolerant of Eligard and had a severe local reaction to it. I had PSADT of less than 3 months and PSA at 5.0 when I started it. PSA remained between 0.1-0.2 for about 4 1/2 years and felt very good on it.

[RICH22 in reply to LearnAll]

yes, have heard 10 yrs max on casodex... i have 2.5 yrs, plus 5mg finasteride and 0.4 tamsulosin. figured i'd try lupron if caso fails. reading your link now. Thnx for reference

[RICH22 in reply to LearnAll]

wow, the combo of casodex and niclosamide looks REAL good!! apoptosis of adt-resistant ca cells always looks good to me. inhibits tumor growth as well? i'm sold. have an appt with MO Thurs. 1/7 - will see what he knows about it... he's fairly up on what i hit him with -- the study was from 2017 so he might know about it. If so, i'll ask him why he keeps at me about getting real treatment for the PCa.... like radiation or surgery. At age 74, with almost a dozen co-morbidities? Not gonna happen. I feel pretty damn good with casodex monotherapy. have no idea what getting fried or cut up will do for me, besides a lovely time trying to heal from all that damage.

[HerbieP]

Hey Geter, I'm just a few weeks ahead of you treatment wise, and a bit younger (59) - sofar chemo's fine. I've had similar treatment history (I also had my testes removed). My PSA is rising (asymptomatic CRPC w/minimal bone & liver mets), and had my first docetaxel chemo infusion 3 weeks ago, second one is this Wednesday.

I had anxiety over chemo, but I had very little side effects. I fasted (prolon fast mimicking diet) so my chemo was on day 3 of the 5 day fast, got in really good shape before chemo, and changed my diet to mostly vegetarian/pescatarian w/o dairy.

I took the anti-nausea meds they give you preemptively, and senna-plus to avoid diarrhea or constipation as well. Yeah I felt weird from the chemo the first few days, my knees hurt a bit from the neulasta, and I got brain fog but these are sacrifices I'm willing to make to extend my expiration date.

[Mascouche in reply to HerbieP]

Hey Herbie, brain fog is a major concern of mine because I am a software developer who is the lone source of income for a family of four (I am 52). You mention having had brain fog following the chemo 3 weeks ago. How long did the brain fog last? Or has it not yet gone away?

[HerbieP in reply to Mascouche]

My "brain fog" is short and mid-term memory forgetfulness and the inability to find words or phrases important to my work (I'm IT Engineering). It's slightly embarrassing but I'm still mostly functional as logic and reasoning seems fine. I find I must use more stickies to keep thoughts, keep and re-read journal, talk less, and focus on one task specifically when working. I'm pretty foggy the first few days after chemo, less so as time goes on. I can complete short term tasks fine, but I still search for words.

I think you'll be fine coding. Comment galore so you don't forget what you're doing. You may be slower (e.g. trying to remember a class) so take the easy sprints. If you find your brain fog impedes your work, you may be able to apply for your work's short-term disability. Brain fog fades away with time.

[Mascouche in reply to HerbieP]

Thanks for the details you've provided. With the brain fog caused by either Lupron or Casodex 150mg, I did not find myself able to work because I was just staring blanky at the screen, unable to pull the trigger on anything so that is slower than slow.

On Casodex 150mg it became even worse as I also began to go through what you've described with words and forgetfulness but I was also making mistakes and found that I could not trust my judgement anymore. On Casodex 50mg, I was able to fight some of the brain fog off using Concerta/Ritalin but at 150mg forget it, I looked like someone with Alzheimer.

[DarkEnergy in reply to Mascouche]

I'm software developer too, did not experience brain fog during Taxotere infusions. I'm a bit careful now talking to other developers because get memory loss when needed on demand. I'll get a url and port number and can't remember it 5 minutes later.

I'm getting really good with Confluence now...

[Mascouche in reply to DarkEnergy]

If you are still undergoing Taxotere infusions you might want to try fasting 3 days before and one day after the chemo. That is what a judge did because she did not want to be unable to be a judge because of brain-fog or chemo-brain and she claims she got out of it okay, with the lone exception being her 2nd chemo session where she had skipped the fasting which was enough for her to decide to fast on all of her remaining sesssions afterward.

[NEHOG]

Once my PSA started going back up, I was moved off Zytiga and onto Lynparza. Too early to tell how effective this will be but oncology is optimistic. Honestly the side effects are different (most significant is fatigue and loss of appetite/nausea) but other side effects are going away.

Big factor is cost--if your insurance will cover this, fine. Some may require an arm and a leg in co-pays for Lynparza.

[RICH22]

that's my category, non-meta HS, dxed GL 4+3, 60% of total samples; PSA 14. -- been on 50mg casodex for over 2.5 years, PSA <0.1 since then. Before caso, used several chinese herbal concoctions, brought PSA down from 17 to 14 but got impatient.

[Mascouche]

I wish I had know this before. I was functional on Casodex 50mg but my oncologist told me to take 150mg saying that my Testosterone was still too high (which I learned after on was a non-sense diagnostic since Casodex does not lower T it only blocks it from being used). At 150mg, the side-effects from Casodex sent me to the emergency room. And now I am reading here that this hardship was for nothing if 50mg and 150mg have the same impact on cancer.

[Guber]

I used 50 mg of casodex mono therapy for two years, and then 150 mg for another 3 yearsI am now on the estrogen patch

[Hidden]

Hi, my dad is also considering to recharge Casodex. May I ask if you have decided the next treament? Is it Casodex or chemo? If Casodex, do you have chance to take the PSA test and is it positve result? Thanks,