Stopping Firmagon if castration resistant

[Finlay66]

The cocktail of painkillers plus Radium 223 is making me very tired at the moment.

This may seem like a daft question but what is the position with continuing or stopping Firmagon when you're castration resistant? Is its purpose to control the spread of testosterone that would otherwise make the cancer even worse?

Thanks

[Seasid]

ADT is for life. You never stop ADT.

[Concerned-wife in reply to Seasid]

Some metastatic men do stop. And do Intermittent hormone therapy.

[Seasid in reply to Concerned-wife]

I wouldn't stop, especially if I am castrate resistant. What did your doctor say? I would add abiraterone or enzalutamide. Which mets do you have? Better ask for second opinion if you can. You don't want more mets. I will look at your profile.

[Seasid in reply to Seasid]

I don't have any visible mets now but I personally don't want to stop ADT. If I would be in your situation I would want to have a PSMA PET scan to see if you have any visible mets now. I would not rush into lung biopsy if you don't know what that lung spot is. I had something on my lung but it resolved after taking antibiotic doxycycline. On CT scan you could monitor if the treatment is effective. I am happy that I did avoid lung biopsy as your lung could collapse and you could end up for 12 days in a hospital. My lung spot was visible on the CT scan but not on the PSMA PET scan. It was visible on the FDG PET scan. Therefore it was only infection which resolved after antibiotics. Don't rush into biopsy if you are not sure if it cancer.

[Tall_Allen]

Yes - much worse - one of the reasons for castration resistance is the cancer gets more sensitive to even the slightest amount of T.

[spencoid2 in reply to Tall_Allen]

what about aberaterone? my MO discontinued it when i became castrate resistant. i have had orchiectomy so don't have to worry about firm-is-gone anymore

[Tall_Allen in reply to spencoid2]

One has to continue ADT, not any of the 2nd generation hormonals if one is resistant to them..

[spencoid2 in reply to Tall_Allen]

thanks that explains it since i have no testicles it would only be adrenals or whatever contributing testosterone and therefor PSA rise. still do not see why they did not try another second generation

[Mw921000000]

my dad is castrate resistant and is on lupron (basically same thing as firmagon). He became resistant to it back in October. He is still on it because there are still some cells that are castrate sensitive (meaning they still respond to androgen deprivation therapies). He takes it in combination with Xtandi, which is approved here in the U.S to treat BOTH castrate resistant and castrate sensitive prostate cancers. Hope this clears some things up for you. Wishing you well