bicalutamide and finasteride

[mikeey43]

I’m on both 50 mg bicalutamide and 5 mg finasteride daily.. no side affects..psa is .4.

The program is 6 months on..then off until the psa rises 3 times..then back on the meds..

[Tall_Allen]

What are you taking it for?

[mikeey43 in reply to Tall_Allen]

for aggressive prostate cancer after radiation and prostate removal

[Tall_Allen in reply to mikeey43]

Thanks. What was your PSA after salvage radiation? Any metastases seen on imaging?

[mikeey43]

it was 3 after surgery rising to 6 in a couple months. After radiation well below 1

[mikeey43]

Radiation in late 2017..slowly rose to 8 in spring 2023..no Mets discovered to date.. my psa started at 99..I think my high D levels have helped

[Magnus1964]

If this treatment is working why stop? A planned 7 mo stopping of a drug that is working doesn't sound like a good plan.

[mikeey43 in reply to Magnus1964]

I don’t think I said a 7 month stop

[mikeey43]

giving it a break enables the meds to be effective for a very long time..

[Justfor_ in reply to mikeey43]

I have a somehow similar belief, realising it not by ON-OFF switching but by dosage adjustment. In principle they are the same.

[CurrentSEO]

if I would do it now, I would do it 3 months on Casodex and then some period off till PSA raises to the the level I started Casodex… or one month on and then off till my PSA raises to the level I started… as my mono 50mg Casodex failed me and started to actually feed cancer in a month seven… I wasn’t expecting it to be so short lasting.

I would also suggest to monitor PSA monthly… as Casodex from controlling cancer to feeding it can go very fast.

Also in your place I would probably use in such program dutasteride continuously instead of Finasteride or even continuously both Finasteride and Dutasteride and Casodex on and off periods. I know using both of them instead of only Dutasteride seems illogical, but I think Dr. Meyers we’re recommending both and some members in this forum use it successfully.

You may also expect some pain in the breast if you remain continuously on Casodex more than 3 months.

You may find here people who advocate to use one drag at a time till it failure and then do the same with the next one, others like to do pulsing and trying to mimic adaptive theory… and of course most of the people use SOC here, after all choices are yours and I wish you good luck with whatever choices you make!

P.S. All opinions are my personal, I’m not a doctor and don’t have randomized trials to back it up my opinions.

[Thinus in reply to CurrentSEO]

I must agree on this. If this is only a trial period, check the PSA every month.

[TJGuy in reply to CurrentSEO]

Did having casodex fail and begin feeding your PC have any other negatives such as make other drugs less effective or no longer a option. Or did this effectively add time to your clock?

[CurrentSEO in reply to TJGuy]

I don’t know for sure of course, but I do have strong feeling that if I went on SOC 3 years ago (July 2020) when I was diagnosed with metastatic cancer and crazy PSA levels … I would have being almost certainly castrate resistant and most likely hormone refractory as well by now.

After dropping PSA from 11,000+ to 8… I let it fluctuate between 100 and 1.8 during next 2+ years.

In between I used Lu-177, SBRT to lesion and Carbon Ion to prostate.

So far my interactions with anti androgens and ADT as follows since diagnosis:

- 1.5 month none of that

- 7 months Casodex mono

- then 6 months none of that;

- then 3 months Orgovyx mono;

- then 3 months none of that;

- then 3 months Lupron mono;

- then 5 months none of that;

- then 7 months of Orgovyx and added for 5 weeks in total Nubeqa (5 weeks will expire end of July);

- August 2023 , will start injecting testosterone with modified BAT protocol and drop Nubeqa 1 week before that and continue Orgovyx on background…

Then will see, idea to remain hormons sensitive as long as possible.

Failure in 7 months of Casodex told me that ADT may not last long as well, so I chose to be creative.

[TJGuy in reply to CurrentSEO]

Congratulations on the Carbon Ion, I assume Heidelberg Germany for that. Yes I have tried avoiding "overuse"of ADT for my condition. And also think I would be castrate resistant had I gone with ADT for life from day one. But I have no actual proof other than six years in and still hormone sensitive.I may be coming up with a decision to make, or not. So I appreciate your comments.

[CurrentSEO in reply to TJGuy]

Carbon Ion in MedAustron (Austria). Heidelberg, Italy and Japan does not offer Carbon Ion for prostate cancer if you are metastatic.

Good luck with whatever choices you make!

[mikeey43 in reply to TJGuy]

it has not failed yet and the combo drugs and Schedule I’m on shudnt fail.. at least that is the story I’ve been told..time will tell..lol

[RonnyBaby]

I'll add a bit to the discussion that MAY be useful to some.

In MY case, I've been taking bicalutamide - 150 mg daily for 2 1/2 years and counting.

I remain 'undetectable' - but there has been a slow recent PSA increase from 0.04 to 0.17 over a 9 month period.

I have few side effects and feel pretty good - all things being considered.

Fatigue is the ONLY side effect that is significant and I can manage that.

I play golf, do yard work regularly and much more - I eat what I want and consume moderate amounts of alcohol. I've taken many supplements (and changed many)- so I'm a clinical trial of ONE.

I'm 71 years of age and had my original Dx over 7 years ago - G9 - Advanced and aggressive PCA + node positive. I had a BCR about 3+ years ago - and a few other treatments (catheter for 4 months + TURP to fix it) - so I've been through a lot - like many of us survivors.

I had radiation and Eligard as first line treatments. I did not have the prostate removed.

Eligard drove me NUTZ - I will NEVER take it again.

In your case Mikeey43 - the finasteride sounds unnecessary to me - but that is coming from a non-medical person (me).

(If I recall from the comments - you've had your prostate removed ?)

I am constantly being monitored (3 mos intervals) as part of an ongoing clinical trail (follow up after completing the trial) - so keeping tabs on what's happening is very imporatant.

Wishing you well on your journey ....

[mikeey43 in reply to RonnyBaby]

Hi All:

One of my medical advisors has been using the combo bicalutamide finasteride for many many years. He has had very successful treatment with guys like us for over 20 years. So he recommends the 6 months on the meds....then you stay off of them until you have had 3 monthly increases in your psa....then back on.

Ronny baby..the prostate is removed...I am the same age as you and overall in good shape.

Current SEO mentions the use of dutasteride....when i got slammed with the initial PSA of 99 my GP put me on dutasteride and my psa plummeted to 25 before my surgery. I have always wondered if the dutasteride should have been continued.

Please note I have only been on the combo meds program for 5 months....so I will be going off them in August. All I can tell you now is my PSA has dropped from 8 to .4 in that period and I don't have any side affects....recent scans show me clean. I am hoping the uptick in the psa takes a while to get going...time will tell.

Best regards to all......Mike

[CurrentSEO in reply to mikeey43]

is it your first 6 months round on Casodex?

What was your PSA doubling time before you started your program of finasteride and Casodex?

[mikeey43]

Also I wanted to mention....I believe my cancer was caused by riding my Ducati. I was clean 2 years before the 99 PSA and during that 2 years I did about 15,000 km riding per year. Underneath the seat of the Ducati is the ecu which I found out gives significantly emf readings similar to a cell phone. The higher the rpm the more emf's. Some of the high powered bikes give emf readings 3 or 4 feet away from the bike.

If you ride...you may want to check that out.....Mike

[j-o-h-n]

Mike got off his bike........

Good Luck, Good Health and Good humor.

j-o-h-n Saturday 07/15/2023 12:03 PM DST

[mikeey43]

no actually I still ride it...however I insulated the ecu with a special metal sheet which stops most of the emfs..plus i reduced the k I ride each year.,

[j-o-h-n]

Mike is back on his bike....

Good Luck, Good Health and Good humor.

j-o-h-n Saturday 07/15/2023 3:39 PM DST

[TJGuy]

Mikeey43. Is there a reason for the finasteride? So you had prostate removed and whole pelvic radiation and PSA progression. I know conflicting studies have shown various results from taking it over many years as too whether it reduces the chance of PC for all or promotes more aggressive PC for some.

Usually finasteride 5mg is used for enlarged prostate, and 1mg is used for hair loss.

Finasteride itself results in a FALSE PSA result of 50% lower value PSA value than it actually is. Now I am assuming that 50% reduction is the same after prostate removal as it is when you still have your prostate. Can you ask your doctor about that?

How often are PSA test you been told to have to check for three roses?

Does your doctor have some study/clinical trials results that prompted this line of treatment that we might read more about?

No side effects, loss of strength, mental fog, hot flashes, breast growth, etc?

Interested to know more.