I have high psa and am waiting on a psma in 12 days, then meeting with a oncologist. Urologist want to start biclutamide and lupron now. I am concerned about side effects. Read some older studies 2017-2019 saying biclutamide as a monotherapy was a good option. Any opinions out there?
Thanks
Pj
You need to weigh your options. Lupron IS the first line standard of care. I have had this disease almost 18 years; I will be blunt. Do you want your cancer to keep growing and spread to either your bones and/or lymph nodes? Then opt out of Lupron. If you think you can handle the side effects (as most of us on here do), then you are doing the best to fight your cancer. I only hope to attain your age. I started on Lupron age 45, when the side effects were REALLY felt. Discuss with your doctor and obtain his/her opinion. I don’t know what you consider a high PSA, but you’re going to help yourself out more by adding Lupron. Just my two cents. Good luck.
Get the bone scan/CT first.
As my Parrot Echo would say 'DITTO'....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 05/23/2023 11:30 PM DST
Given your PSA level, I suggest the time to be taking advice from a urologist, as well-meaning as he/she might be, is likely over. I would follow the advice from a prior reply: see an oncologist that specializes in prostate cancer at the best cancer center you have the ability to visit. There are a number of options based on the specifics of your situation, but you should definitely get advice from a doctor that is following the latest diagnosis and treatment developments in real time.
Bicalutamide before PSMA PET scan may increase the PSMA expression of the cancerous cells, thus improving detection capability. Depending on your burden, Bicalutamide can buy you some time with limited SE (gynaecomastia-Tamoxifen can prevent). For low burden it is more than powerful enough. My anectodal case, documented in my "Bicalutamide Maneuvers" thread proves this. Whether is enough for your case, you will only know after trying. Docs use one size fits all approaches.
Agree it is worth considering bicalutamide monotherapy as an option to possibly have much better QOL lower SEs vs Lupron type ADT. Radiation to breast tissue is easy to prevent gynecomastia though tamoxifen works too. Bicalutamide worked for me for 4.5 years before failing and had to go on to other approaches. That was over 10 years ago and am still HSPC. Well worth it for me as I do not tolerate Lupron/Eligard ADT well. I chose bicalutamide monotherapy in consultation with Celestia Higano, a top PC oncologist.
Abiraterone, Prednisone, Zometa – Without Lupron?
Lupron 
Lupron
