Treatment Decision

[dac500]

MO has agreed to let me restart Lupron because of CT result showing size increase of couple of existing metastasis in lymph nodes and a new suspicious lymph node. But he wants me to take Bicalutamide for two weeks before that. Do I understand correctly that Bicalutamide prevents prostate cancer cells access to testosterone, but it may increase testosterone. Since cancer cells are deprived of testosterone (castrate sensitive cells), does this imply PSA may go down on Bicalutamide?

[Tall_Allen]

The reason you start them together is that Lupron creates a surge of testosterone that may last 7-10 days. The Casodex prevents the temporary surge of testosterone from activating the cancer in your metastases. After that, your pituitary sends out a signal that shuts down completely all testicular production of testosterone and the Casodex is no longer needed.

[Hidden in reply to Tall_Allen]

Wow! I hope it works for this friend!

[6357axbz in reply to Tall_Allen]

As an alternative will using degaralix instead of the first Lupron injection prevent the flare up?

[Tall_Allen in reply to 6357axbz]

Yes, definitely.

[Magnus1964]

My choice would be to stay on bicalutimide with Lupron. Why give the cancer the chance to develop new cell lines resistant to bicalutimide. A very useful tool in your arsenal.