Assumptions to increase life expendency

[Burnett1948]

I have been on Lupron since August 2020. If

I stay on Lupron for a total of 3 years

total I could become Castrate resistant. My

understanding is that I will then not be able to benefit from physical castration to get extra years of life. Please help me understand.

[Howard53545]

My understanding is that you may never become castrate resistant! There are dudes on lupron for years!

[Magnus1964]

Lupron is a gonadotropin-releasing hormone which suppresses testosterone. Some patients have intolerable side effects with Lupron and may have an orchiectomy.

If you fail Lupron that does not mean you are castrate resistant. You can still go on ADT drugs such as casodex, zytiga, xtandi, etc.

[Burnett1948 in reply to Magnus1964]

Thanks Magnus1964

[Burnett1948 in reply to Magnus1964]

Magnus1964 I was just reading Doctor Google about what causes Brain Fog. It said changes in hormones. Well I would think Lupron would change my testosterone level and for me that makes sense. Do you agree.

[Magnus1964 in reply to Burnett1948]

I would not put too much faith in dr google. However, I would agree that lower testosterone levels will cause a reduction in brain function. Everyone is different and will experience different levels of reduced function.

[Hidden]

Castration means T < 50 ng/dl.You can become castrated using meds or having a oriectamy. Both have the same result...T < 50 ng/dl.

If you become castrate resistant, your pca developed many more AR receptors and can now thrive in an extremely low T environment.

Becoming physically castrate ( ie testicles removed) will provide no benefit except no longer needing to take the meds (Lupron. Eligard, etc).

[Burnett1948 in reply to Hidden]

Thanks TomTom1111.

[addicted2cycling in reply to Burnett1948]

TomTom1111 wrote ___ " ...Becoming physically castrate ( ie testicles removed) will provide no benefit except no longer needing to take the meds...

I'm a 5+5 who got CASTRATED from the get-go. The BENEFIT for me was NO DRUGS AND MORE COMFORTABLE BICYCLE RIDING!!!

My 71st BIRTHDAY is in 3 days with a planned 143 mile birthday bicycle ride BUT I crashed on Sunday at mile 100 of 102 (just 2 miles from home) and as a result in 3.5 hours I'll be having X-rays on my left shoulder to see what damage I did.

Maybe drugs would have been better and safer. 😁

[Burnett1948]

Nalakrats my PSA is now .006. I am doing well on Lupron. I remember reading that this hormone will give be about 1.6 years of life. So my thinking is and I am always trying to find ways to get more life. I was hoping I could manage for physical castration to give me more life.

[Tall_Allen]

Castration resistance just means that your cancer will progress in spite of castration; however, it will progress faster if you don't have some kind of castration. One of the reasons for castration resistance is the "upgrading of the androgen receptor." That means your cancer will be able to grow with much less testosterone than it is now. You will always benefit from chemical or physical castration. In fact, the benefit will be greater when you are castration resistant.

[Burnett1948 in reply to Tall_Allen]

Thanks Tall_Allen

[GP24]

You have to check your testosterone level. If it stays below 0.7 nmol/L the ADT may work for ten years (from a presentation by Laurent Klotz):

Graph showing how testosterone level predicts how long ADT will be effective.

[Burnett1948 in reply to GP24]

Thanks GP24. Can you help me read Laurent Klotz presentation and how do I keep testosterone level below 0.7 ?

[GP24 in reply to Burnett1948]

Its in this presentation "Minimizing Morbidity and Maximizing Outcomes with ADT" at about minute 18.55. He recommends trying a different drug if this low testosterone level is not achived.

grandroundsinurology.com/mi...

[Burnett1948 in reply to GP24]

GP24 Could you sent this to me again please so it comes through on my Computer(lap/top) so I can print the file out to show my oncologist and save it. My computer has just been serviced and I lost it. Many thanks.

[Burnett1948 in reply to Burnett1948]

GP24 cancel my request I just found it. Sorry. Burnett1948

[Burnett1948 in reply to Burnett1948]

Thanks GP24fromBurnett1948

[Burnett1948]

Nalakrats I hope you got my correct history and hope you are right: Burnett1948

[Burnett1948]

Burnett1948 I have been on Lupron for about 9 months and my Radiation Oncologist has mentioned she might give me a holiday. So my interpretation of what you are saying is “another 8-9 months” on Lupron at current PSA to get a holiday? Thanks Nalakrats.

[Burnett1948]

Burnett1948 Thanks for your assessment Nalakrats.

[Burnett1948]

I got the 1.6 years from the Stampede Trial I think.Burnett1948