how long is casodex normally taken before zoladex ? The last time he was on it he took both for 16months , this time the oncologist said come in for zoladex tomorrow, I asked should he not be on casodex first he just replied yes ok come and get a prescription, I am a bit concerned he wasn’t going to offer it … we are in Bahrain at the moment .
(psa has just gone from 0.2 to 0.5 in 8 weeks ).
Two weeks. It’s only to prevent a testosterone flare.
thanks . I am off to collect the prescription today hopefully
if he is on a regular schedule to continue with Zoladex ADT, then he does not need to take Casodex for the second and subsequent doses as there will be no testosterone flare.
Of more concern is the sharp rise in PSA if he has been on continuing ADT with the Zoladex. He should have his testosterone level checked. It should be less than 50 ng/dL ( castrate level). If it is below that, and PSA continues rising, then he may be becoming castrate resistant. That would call for a more potent addition to the Zoladex, such as Zytiga, Xtandi, or Nubeqa. But Casodex would not be an optimal choice.
Please have him post more details of his cancer history details in the profile.
he has been off all meds since feb 2020 and only in the last 10 months has his psa gone from 0.03 to 0.5
0.03
0.04
0.07
0.12
0.2
0.5
OK, that clears it up. And it is a relief to see that he is BCR but not castrate resistant. So yes, one month of Casodex to prevent flare from restarting it is a good idea. Hopefully, with ADT then suppressing testosterone the PSA will drop to very low level again.
Also, with his PSA now at 0.5 it would be a good time to get a PSMA PET scan to determine where any remaining cancer may be lurking and effective targeting treatment can be considered.
Thanks for providing that clarification.
he had a pet scan a few months ago , I thought it was too early but they went ahead and said it could be baseline scan , it showed two suspicious areas , he was stage 4 at diagnosis with mets to t12 and a pelvic lymph node , he has done so well but struggles for stamina these days
My circumstances were different and was only prescribed Zoladex for 12 months with IMRT and brachytherapy. I expected the ADT to last at least 18 months but the radiation oncologist said statistically the survivability is the same for my age (71 years), for 12 or 18 months.
he started casodex today , he is 62, this is the second time on it , he was on it 16 months and has been off it 2 years 10 months before his psa rose to 0.5
Told to discontinue Casodex (Bicalutamide)
Casodex and headaches
Stop Casodex if on Lupron and Zytiga?
Firmagon or Zoladex....? 
