Casodex

[ElRanchoDePoisonIvy]

Is anyone doing only Casodex for their ADT together with their salvage rad? Are there any disadvantages for a six month course? Seems like it would make T recovery less of a problem.

[Magnus1964]

Casodex will weaken cancer cells before the radiation. Continuing Casodex after radiation would be advised.

[Justfor_]

T recovery? If you intended to write "recovery" from supra physiologic levels to normal ones, then yes, it will take 1-1.5 months after stopping taking it. My tT was 800-900 before taking any drugs. Starting on Avodart it spiked to 1500 relaxing to 1200-1300 after more than one year. Starting on Casodex, my all time high has been 3200 (all endogenous). At my current dosage of 1.5 tablet per 2 weeks tT has bottomed down to 1700-1800.

[Tall_Allen]

Gynecomastia. It is a weak antiandrogen.

[Ian99]

I was diagnosed in 2014 with locally advanced pc. Took only Casodex as ADT till 2021. RT in 2015. Details in profile. I found it tolerable.

[Bethpage]

Back in 2019, I approached the forum with this question re ADT & salvage RT. You can look at my husband's profile. He had a simple prostatectomy in 2014 because of BPH and 11 consecutive years of negative biopsies. A well-known surgeon in Celebration, FL, talked him into a salvage surgery in 2017 (now we know how stupid that decision was, but the surgeon is known world-wide and we were naive). Finally, in late 2018, a PSMA (end of phase II trial of what the FDA would approve as Pylarify) at Stanford) found the BCR in the prostate bed. My husband has had mild but progressive cognitive impairment for 20 years so we were looking for any possible alternative to Lupron or Firmagon. T_A suggested we "might get away with" bicalutamide for about 3 months prior to 39 RT and for a total of 2.5 years. In this forum, T_A and others have stated many times that bical against Lupron or Firmagon is "like a BB gun to a bazooka" and that when bical fails, it then feeds the cancer. As my husband's PCa seems to be on the less aggressive side and fearing the QOL issue with increased cognitive impairment, he decided to take the risk on the bical. He did start to develop gynecomastia around the end of month 2 on bical. I came back to the forum and T_A suggested to try Tamoxifen @ 10 mg/day. Allen did warn that Tamoxifen might not reverse gynecomastia that was already in progress. Happily, Tamoxifen did reverse my husband's gynecomastia. He had no other side effects whatsoever from the bical. His total time on bical was 2.5 years ending in September of 2021. Husband followed T_A's suggestion on duration on bical. Time will tell but he was undetectable last week. There has been no unusual progression of cognitive impairment. I wish you good luck!

[ElRanchoDePoisonIvy in reply to Bethpage]

Thanks for your insights. I’ll also pass this on to my FIL, who has gynecomastia.

[SallyJones]

My husband took Casodex for only two months prior to 45 radiation treatments. At the same time has been receiving Lupron or Eligard shots every 3-4 months, which are continuing. His tx is for stage 3b and started in February 2022. PSAs are down to .014. But do not have anything else that I could share that would be at all helpful. I will say prayers for you along with for all the others struggling with this cancer.

[Jimrazz56]

I am currently taking just Casodex to treat my metastatic prostate cancer.

First underwent prostatectomy in 2015 but rising PSA let to round of IMRT in 2016. That helped keep PSA low for five years.

As PSA started to soar in 2020, started dual regimen of ADT injections (Trelstar initially then Lupron) every three months while taking 160 Mg of Xtandi daily.

After two years my PSA finally dropped to 0.06 and I opted to take sabbatical from ADT but wanted to take just Xtandi. Oncologist informed me that FDA only approved Xtandi as dual therapy with ADT and suggested Casodex as an approved mono therapy.

So far it has helped bring PSA down with side affect of Gynecomastia (man boobs!). I’m also a little concerned that my PSA had minor uptick in last measurement (.08 to .10) but will see where it lands in two more months.