Had my first shot of Eligard (6 month dosis Leuprolide) 3 months ago and got my PSA test today, which was 13 3 months ago it was 6,5. It seems like Eligard/Leuprolide doesn't work for me. Before my first shot of Eligard I was on Bicalutamide for 2 years which had effect the first 1½ year. Isn't strange that Eligard/Leuprolide doesn't have any effect at all? Is there any alternative to Eligard/Leuprolide?
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Jurasuje
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Have your testosterone tested to see if it's at castrate levels, ideally below 20. If it is, the Eligard is working. If you are still taking Bicalutamide (Casodex), I would stop because that can feed the cancer. If your testosterone is below 20 and your PSA continues to rise, you are likely to be castrate resistant and may need to add a second-line androgen drug such as Xtandi or Zytiga.
I assume you did discontinue the bicalutamide... if so, at what date? It can take about four weeks for it to wash out of your system. If it had turned into an AR agonist and was feeding your cancer, as it sounded like from your rising PSA, I believe it is possible for PSA in some men to keep rising even after that four weeks.
So the fact that the Lupron does not seem to be working (yet) may be related to your use of bicalutamide.
Yes, I don't claim to understand exactly what happens there... I guess maybe when it fails we could say it might have been feeding the evolution/mutation of the cancer, rather than the feeding the cancer itself?
A few months back (when it was failing for me, after well under a year) I was looking at some case studies of "antiandrogen withdrawal syndrome." It was very interesting to see what possibly happens, although to a small number of men, after they stop bicalutamide and are in between that and a new therapy. Different men can respond very differently to its withdrawal!
As gregg57 implied, it's rare that leuprolide doesn't control your testosterone, so it may just be that you are castration resistant. If it's controlling your testosterone, keep taking it anyway.
But it's time to roll out the bigger guns. You are not detectably metatstatic, so you qualify for any of 3 drugs - darolutamide, apalutamide or enzalutamide. Some find that darolutamide (called Nubeqa in the US) has fewer side effects.
First, what was your T level? if up then yep its not working. In my recent case I had a 6 month shot, not my choice, and my T hit 125 at 2 1/2 months and psa had risen to 2.18 from 0.76.So then had a one month Lupron shot. Reduced T to less than 5 and psa to 1.45.
All that said however my T says low 2 months later but psa is, as of 6/15, 1.72 so I just today, 6/16, started on Nubeqa.
BUT - BUT - my experience is not necessarily yours!!! My journey is now in its 6th year and started as a Gleason 9 (4+5) with psa of 20.6.
My personal opinion is that any hormone shot should only be one month and both T and psa should be tested monthly. Doc might disagree but it is your choice and cheap tests.
Please private message me with your updates so we can compare.
REMEMBER we are all different in our path with this disease.
Since metastasis in 2004, always PSA and T tested; plus a host of other markers. Always a 3 month inject of Lupron or Eligard. First year, blood work done monthly. Second year, blood work done bi-monthly. Third year blood work done quarterly. ADT stopped in seventh year. Tenth year, blood work offered semi-annually; I declined. Fifteenth year blood work offered semi-annually; I tried once, However, I was a nervous wreck for the very first time since 2004. My choice today remains blood work every quarter.
Blood work coincided with a visit with the medical oncologist and his/her Oncology Nurse Practitioner. I have no worries. I am very comfortable with this schedule. I just want to stay on top should there be any changes. As you stated, we are all different. We all have various stress levels. Reduction of stress is paramount for me. I wish all the best.
Eligard made me angry and short tempered plus short on breath and fatigued. I’m now taking flutamide and finasteride. One capsule 125mg and one tablet 5mg early AM. Been about a year with the oral treatment. So far so good. I hope this helps you. I think my prayers to Jesus and His Father help me a lot.
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