Lupron shot timing

[ck42]

Urologist persistently delays my shot for 20-30 days past the 90 day mark. ( getting 3 mo shot ) Oncologist refuses to get involved. Any opinions or similar experiences ? I am nearing 3 year mark of Gleason 9, stage 4. Doing very well so far with undetect PSA and tolerable side effects. 79 yo, otherwise healthy, vigorous exercise.

[RyderLake2]

Hello, You are not the first person to write about friction between your urologist and oncologist. Have your family doctor give you the shot.

[LearnAll]

By giving an ADT free gap of one month every 3 months, you are allowing some T to cancer cells. intermittently ..This might keep you androgen sensitive for longer duration.

[teacherdude70 in reply to LearnAll]

My personal experience supports a rise in T toward the end of the non-monthly Lupron shots. Have heard the same from a few other men. Plus my RO and her staff agree.That said I only do monthly Lupron now. And am on Nubeqa since June 2021.

My only contact with urology docs is to get help with sex. Yes surgeons love to cut but RO docs love to zap you. However my RO admits if cutting will give better results will say so.

[Hidden]

If you have have stage 4, I don't see why you need to keep a Urologist and you should have an Oncologist who is more involved IMO. It's a 3 month shot, so you should get it every 3 months. I would think there should be some flexibility on that, but in my case I have seen twice where my testosterone has gone up slightly at the end of the 3 month timeframe, although I can't be sure when it happened exactly. There was also a corresponding small rise in PSA. Definitely don't need that to happen.

You don't have to guess about that though, just have your testosterone tested, preferably right before you get you shot to see if it's making a difference.

[rscic in reply to Hidden]

AGREED .... others agree as well.

[Mormon1 in reply to Hidden]

Ditch the uro

[Tall_Allen]

What is the point of letting your T rise by such a small amount? Do you feel better with the 20-30 day breaks?

[ck42 in reply to Tall_Allen]

This delay is in no way desired ! The urologist, ( who first diagnosed my problem ), says 20-30 days late doesn't matter.

[Tall_Allen in reply to ck42]

It does matter. Even a few days late can make a difference. Why are you still seeing a urologist anyway?

[Gabby643 in reply to Tall_Allen]

TA, I went through this same problem. I dropped the Urologist and went with the MO.

[dac500 in reply to ck42]

I had the similar problem with an urologist. He gave me two 3 month Lupron shots during my treatment for local recurrence without any blood works. When my cancer spread to multiple abdominal and pelvic lymph nodes I moved away from the urologist. During last years I am getting full panel of bloodwork from my MO every three months.

[Hidden]

Here's an article I found on the subject.

pubmed.ncbi.nlm.nih.gov/330...

[NotAlwaysSunshine]

My thoughts exactly. We have not seen a urologist since diagnosis. MO -only.

[spw1]

When my husband's T was measured towards the end of the 3 months' injection, it was already rising. The injections do not always keep T down for exactly 3 months. I think that it is important not to have a small gap in between the injections. Can you change the urologist? We do not see my husband's urologist as he was uninterested and incompetent. We get the nurse from the company to administer the injection now. Oncologist monitors the bloodwork.

[dhccpa]

I got rid of my urologist for his constant BS.

[Sandy752]

Getting 4 month Lupron shots for almost 8 years. Family doctor gives them. I stay on schedule (its up to me to get drug and schedule shot) but once missed by almost 2 months. No longer have a urologist just a radiation oncologist.

[Magnus1964]

Maybe he/she thinks they are doing intermittent ADT. Ask him why, you are entitled to an answer.

[Explorer08]

I had RRP just over 10 years ago. Gleason 9. I came to realize that my urologist's expertise was surgery - - he is very good at it. His expertise in cancer, however, was somewhat limited. I took the advice of several on PCa forums to get an oncologist on board and I am very glad that I did. I engaged with a urologic oncologist at a university school of medicine setting. As a Gleason 9 I was pretty much destined for recurrence which did happen after 9 1/2 years. My oncologist is the lead on my care.

[ck42]

Thanks for all the replies - it appears that the problem is the urologist - will change that shortly. My testosterone has fluctuated from 11 to 51. I suspect Lupron timing is the reason.

[Hidden]

Tidbits I have learned since March 2003:

After initial DX by Urologist with a Gleason 7 (4+3), 6.8 PSA, I never saw him again. I moved on to two Radiation Oncologists. One for seeds; the other for a short course of IMRT. My initial treatment plan called for the dual radiation treatments.

Each did nuclear bone scans and soft tissue CT scans as a base line. I have since had 24 scan. The last in 2016.

When metastasis was found at T3 & L2, my first RO gave me my first injection of Lupron and told my that anyone can give the injection.

I was referred to a Medical Oncologist who continued to either a three month Lupron or Eligard injection for the next six years.

Even today, over 18 years ago, my cancer is managed by one person, my Medical Oncologist. I have not visited my previous doctors. Interesting that one of the ROs calls me every five years to check on me. He is the one who gave me the MO referral.

My Cardiologist is involved and receives my quarterly tests. He as well tests for his area of expertise quarterly.

Since March of 2003, I have always had PSA and T tested. Early on in this was monthly. I continue with quarterly PSA and T even today. This is my comfort zone.

My last Lupron injection was February 2010.

My Medical Oncologist told me early on that our goal was to have T at less than 5. I succeeded so well that my T never came back after stopping Lupron. In January 2011, my MO prescribed 4 mg of Androgel twice a week in an effort to restart T. T never restarted. A year later, to continued with supplemental testosterone and continue to do so today,

I had reason to see an Urologist two years ago. I gave him my complete testing results for an overview. This led to an interesting discussion of my journey as one of his medical school Professors was my Medical Oncologist.

Timely injections are important. My best advice is to find someone who can keep to a timely schedule.

Gourd Dancer

[Atlpapa in reply to Hidden]

I'm not sure if "mets to L2 & T3" are spots on the spine or bone somewhere else (sorry not familiar with the acronym). If it is on the bone I was surprised to hear you were able to get off ADT in 2010. I have mets on the pelvis bone and am thinking I'll be on ADT for life. either way best of luck and keep up the fight. And thanks for sharing.

[Hidden in reply to Atlpapa]

I apologize. L2 is the 2nd vertebrae of the Lumbar area of the spine. T3 is the 3rd vertebrae of the thoracic area of the spine. Metastatic lesions were resolved with chemotherapy and damage was replaced with new bone growth. Lupron was stopped when my guy could no longer find cancer in my body. He convinced me to stop by telling me if PSA rises, then we restart Lupron. “Don’t you want to find out if I am right?” Same with the testosterone and low dose Androgel. I am most fortunate.

GD

[Atlpapa in reply to Hidden]

That is great to hear. I've been on Eligard since dx in Feb 2020 also Xtandi at that time but just switched to Erleada due to SE. I had the bone mets at dx. So you did chemo and started the ADT when bone mets were found. You mare very fortunate. Very encouraging to hear your success!

[dadzone43]

Surgeons cut.

[j-o-h-n]

Tell the Urologist if he doesn't want to give you a timely shot... then tell him you're going to give him a couple of hand free DRE's.......... then drop the SOB.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/08/2021 10:39 PM EST

[Mormon1]

Ditch the Uro. The oncologist scared to make ememies. Maybe you should find a new Oncologist? Good luck