Hi Folks, I am currently on Zoladex & have been for 3yrs I'm sure Xtandi will be next.
My question is I was only on Casodex for approx 1 month just before early Chemo then moved to Zoladex, can I revisit Casodex later on or combine it with something else.?
I noticed some people where on Casodex a lot longer than 1 month.
Many thanks
Gary
I think you may be able go back on casodex. One month may not be enough time for new cancer cell lines to find a work around.
Hi Magnus that's sort of what I was hoping, does Casodex have to be combined with something else or can it be taken alone.
Cheers
Gary
I was on casodex as a stand alone treatment for 5 years. That was a long time ago. Today it is used in conjunction with other treatments. Somehow I think big pharma is influencing this. They would rather physicians use the newer and more expensive ADT drugs for long term use.
Magnus, you are an inspiring grain of hope. Have you had chemo?
I have not had chemotherapy yet. I kept avoiding that in-spite of more than one doctor wanting to give it to me. I guess I am saving chemo as a last ditch effort.
Question. How old are you? Born 1964 would make you 57 years old? My guess..... Keep up the good work.
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 10/05/2021 9:59 PM DST
John,
1964 is the year I was graduated from from high school. I am 75. Just another old fart.
75 is young!!! Keep young..... (ps I was never good in math)...
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 10/06/2021 12:31 PM DST
There are more effective drugs than casodex. I f I understood correctly your cancer progressed after chemo. The PSADT seems to be less than 6 months. I believe you should discuss treatment with abiraterone, enzalutamide or apalutamide which could provide a better control of the cancer than casodex.
Hi tangoNope my cancer didn't progress after chemo I was put on Zoladex during chemo instead of continuing Casodex, I know my next option is probably Xtandi (Enz). I was just asking if I could still revisit the casodex later on down the line as I was on it for only about a month to 6 weeks.
Cheers
In your profile you said:“Oct 2020 PSA Rose found a spot on my L2 treated with high dose Radiotherapy. April 2021 L2 fracture possible RT cause.”
If your PSA rose and a new met was found your cancer is progressing after chemo and Zoladex.
Th treatment should be continuing with zoladex and adding zytiga or Xtandi, You could also request Provenge a vaccine which offer a survival advantage .
You need to consult about bone agents such a denosumab or zoledronic acid if the cancer is causing fractures,
Hi Tango sorry I thought you meant my cancer progressed straight after Chemo, my bad.The orthopaedic surgeon doing my operation at the end of Oct isn't convinced now the Hi dose RT was the total cause, he seems to think because of my bad back it would have happened anyway the RT just made it happen a bit earlier.
I probably need to change my profile. 😊
Cheers thanks for the Info.
Gary
No. Casodex is often used at the beginning to prevent a flare-up of your metastases. Once your cancer has become castration resistant (rising PSA or new metastases while on Zoladex), there is no role for Casodex (a weak anti-androgen). It is time to bring out the big guns (Xtandi or Zytiga).
TA, question:
Casodex is an older ADT drug and granted less potent than zytiga or xtandi. But in the end they all fail, whether in a month, a year or 5 years. So my question is, if you start with casodex then move on to zytiga then xtandi, apalutamide, etc, you would get more life out of the castrate sensitive period as I did.
I realize that everyone responds differently and their Pca is different, i.e. Gleason, mets etc. But in some situations beginning with casodex might make sense. Would you agree with that?
Just the opposite. Longer time to failure from second generation hormonals. It NEVER makes sense for a newly diagnosed metastatic man to start with Casodex.
You did NOT get more life out of the castration sensitive period, you probably made it shorter
A patient with DISTANT mets should probably start with a second generation ADT. But for localized Pca I would think trying to extend the castrate sensitive period would be desirable.
Currently, being able to put Pca in remission is mostly temporary, i,e, months, years, so why not try to extend those remissions.
Some terminology: "localized" PCa means that it is only in the prostate or very nearby in soft tissue (Stage T1-T3). "Locally advanced" means that it has spread to soft tissue nearby (stage T4) and/or pelvic lymph nodes (Stage N1). For many men with locally advanced PCa, their cancer can still be CURED by a combination of radiation and hormone therapy. A STAMPEDE trial just last week proved that abiraterone and ADT combined with RT had much better results than ADT+RT for men newly diagnosed with N1.
"why not try to extend those remissions." that is exactly the purpose of early use of second line hormone therapy. It has been proven to extend the castrate sensitive period and to extend survival.
I don't understand why I made my castrate sensitive period shorter. I think 29 years is pretty good.
Somehow, we are not looking at this on the same way and I am too tired to continue.
All anyone can go by are the averages in the trials. How can any man possibly know what would have happened had one done something differently? It is pure imagination on your part. When you were diagnosed, we didn't have all the data we have now.
Zytiga, Xtandi, and Erleada, when added to ADT have been proven to extend the period in which mHSPC patients remain hormone sensitive.
OK thanks guys just thought I would ask.
Zytiga usually has less side effects and can be combined with prednisone then dexamethasone to squeeze out extra treatment time. Continue Zytiga until disease progression is shown on scan—not just because PSA rises.
You can learn from our mistakes.
Hi GrumpyswifeThanks for that info, not sure if I get an option but it's either Zytiga or Xtandi yea I still want to work so the least amount of side effects will be better.
Cheers
Hi, my dad is newly diagnosed with PC and was given Casodex. He noticed that after taking it for a few weeks, he started having skin rash and itchiness. Can someone advise on how to alleviate this effect?
Favorable Casodex withdrawal 
Casodex
Adding Casodex
Casodex and PSA
Continue Casodex or move to Lupron?
