Casodex query

[Walliam]

About to go back on ADT this month because my PSA is doubling every 4 months My Nader was 0.02 in April 2021 but recent bloods are showing 2:6 and I’m expecting 5 plus on bloods done yesterday I was told in March this year that I had incurable cancer after a clear PSMA scan on the previous February .So my MO wrote me a script for Decapeptyl and Casodex When I went to collect my script the Pharmacist noticed that along with the Decapeptyl there was a six month supply of Casodex We both failed to contact my MO for an explanation, Can anybody give me an idea as to what or why I got a six month supply… I thought it might be a 4 week supply of Casodex as was the case the previous time I went on ADT.. Thanks

[Tall_Allen]

Is abiraterone approved in Ireland?

[OzzieJ in reply to Tall_Allen]

Yes, abiraterone is approved. I’m on apalutamide (Erleada) for recurrence after prostatectomy. Other drugs like darolutamide and enzalutamide also available. If your consultant recommends the drug generally you can get it.

These drugs are provided on the public health scheme which provides all family medications for a max contribution of €80 a month.

[Tall_Allen in reply to OzzieJ]

Much better than Casodex.

[Walliam in reply to Tall_Allen]

Hi T.A .My MO has put me back on the same treatment as I was on 5 years ago before I had Cyberknife …Casodex and Decapeptyl it feels like I’m getting nowhere fast.I think he’s all out of options.Thanks for reply Walliam

[RyderLake2]

Hello,

Four to six weeks is the norm. Casodex is given to prevent the flare that occurs with most (but not all) ADT drugs. Never heard of Decapeptyl. In North America medical oncologists usually prescribe either Xtandi (enzalutamide) or Zytiga (abiraterone acetate). Hope that helps.

[GP24 in reply to RyderLake2]

Decapeptyl is Triptoreline

[Walliam in reply to RyderLake2]

Thanks for your post RL2

[Lettuce231]

When do you see your oncologist again ? I would ask if he meant to prescribe 6 weeks not 6 months. I would imagine he is preparing you for Zytiga or something similar 🤔

[OzzieJ]

As others have said when I went on Decapeptyl I think I had about 6 weeks of Casodex. It was just a short period - certainly not 6 mths.

I also was put on an additional hormone drug (apalutamide) so might be worth asking about that.

[Walliam in reply to OzzieJ]

Thanks for response.From the information I’ve seen it looks like it was 6 weeks not months that he should have subscribed . I’m not very impressed with him to be honest it feels like I’m going back to where I started 5 years ago.If you could recommend an MO to me I’d appreciate it .I’m currently attending St Vincent s private in Dublin

[OzzieJ in reply to Walliam]

So am I so we probably have the same oncologist. Maybe Blackrock clinic has someone or else go to London?

Maybe they are waiting to see how your PSA responds to the ADT and perhaps add an additional hormone drug like Erleada. That’s how it worked for me. You could also ask if early chemo is an option (not saying it is, but might be worth exploring). Might be worth giving the oncology nurses a call. I have always found them really helpful and can give you a steer as to the next steps.

[Walliam in reply to OzzieJ]

Thanks I’m assuming if I call the desk at Vincent’s they can put me through to the Oncology nurses

[OzzieJ in reply to Walliam]

Yep. You are looking to be put through to daycare oncology. I would speak to someone and explain your situation. I had chemo up there and they are monitoring all my bloods and scans while I’m on ADT. I assume that you will need to have a blood test regime with them since you are back on ADT. Sorry you are back dealing with all this again.

[Walliam in reply to OzzieJ]

Thanks Ozzie . I’m more disappointed than anything else. It doesn’t come across to me very well when you’re questioning your MO and he looks at his watch …..And like I said no fresh ideas only back to where I was 5 years ago.Just like starting over and it feels like nothing really has been achieved

[Magnus1964]

That would be unusual here in the States. Sometime I will get a three month script but six is overboard. Does your MO plan to stop Casodex at six month? If so I would question that. If a drug is working why stop?

You need to speak to your MO. Hold his/her feet to fire on this.

[Walliam in reply to Magnus1964]

I completely agree with you.I would assume when he also prescribing Decapeptyl it would be short term not 6 months Thanks

[Magnus1964 in reply to Walliam]

That I don't know. Question him about that also.