Abiraterone SE when added to Lupron?

[jackwfrench]

I am a PSA =2, low volume, oligometastic HSPC. I got my first Lupron shot 4 weeks ago. I started to get a couple hot flashes per day in the last week from the Lupron and of course I expect fatigue to kick in over the next six weeks. What additional side effects might I expect by adding the abiraterone in the next week? Thanks -

[GoBucks]

I was lucky that no extra side effects were noted except my liver functions went haywire for awhile. Hot flashes & fatigue. Exercise helps both and your mind.

[Jewelrylady in reply to GoBucks]

Did liver function return to normal. Did you need to change your medication. Some of my husbands liver labs were high. He’s having them retested this week. Doctor said this can happen, but then they can return to normal

[GoBucks in reply to Jewelrylady]

My liver numbers climbed just short of 5 times higher than normal. That's the number where you stop. I stopped for 7 weeks and everything went to normal. I restarted at 1/2 dose( 500mg) and numbers were ok. I moved up to 750 mg and stayed there. Luckily I was always undetectable.

[fireandice123]

For me adding Abiraterone to Lupron didn’t cause additional SE’s but it did increase the intensity of them - mainly hot flashes, fatigue, and weight gain.

[Gearhead]

My understanding is that any additional SEs after starting abiraterone are most likely a result of too much or too little prednisone. Others please help me here, but I think things to be alert to include increased hypertension, edema, and fragile skin on forearms, for example,

[London441]

Testosterone suppression is the primary driver of side effects by far. The Lupron is doing most of that. Additional SE’s from abiraterone are minimal by comparison, unless you have liver or BP issues.

Don’t worry about the abiraterone. Instead focus on weight bearing and cardiovascular exercise for superior results. They are the best solution for all ADT sides, indispensable.

[jackwfrench in reply to London441]

Thx - hey you alluded to data relating exercise to CR push out etc in a prior post - where can I go to see some of that data?

[London441 in reply to jackwfrench]

I don't post links, as it can appear I am asserting their content as fact. In truth the impact of exercise on prostate cancer outcomes specifically is in the horse and buggy stage.

Regardless, if you search for the work of people like Christina Dieli-Conwright, PhD, MPH (Dana Farber), Dr Mark Moyad (U of Michigan), Australian exercise physiologist Jennifer Chan and others. You can find some hard data from them.

Keep in mind that even if the data for CR delay and pca survival benefit is not nearly as far along as it should be, there is an abundance of data detailing the longevity- and quality of that longevity- that exercise promotes. It is more profound than even the hyperbole that surrounds it will tell you.

If you want to help yourself to some of that, Dr Peter Attia, who specializes in longevity medicine, is a great resource. He describes in detail how and why exercise is the most important metric associated with longevity-by far.

[jackwfrench in reply to London441]

Great, I have new books on my reading pile from Moyad and Attia, will check out Christina, Dana, and Jennifer.

[OzzieJ]

I’m on apalutamide for the last six months. I didn’t notice any difference when it was added to ADT. As other have said getting out and about is the best way to avoid side effects even if part of that is just to take your mind off them. Hope it goes well for you.

[ChristopherM123]

I started on lupron and abiretarone soon after. I use clonadine for the hot flushes. I sourced the abiretarone from India. It worked very well for five years then stopped working. I was on a radium 233 trial for six months (never again, awful side effects), and am now on enzalutamide ( again, from India)

[Clays711]

Check the Mayo Clinic site on abitaterone. There are more possible side effects listed there. My MO and urologist had no idea where one of my side effects came from. I found it there.

[OldWarrior]

most notable “extra” side effect from abi for me was foot and lower leg cramping at night - really painful. Bananas and V8 juice was an effective remedy

[jmarsh]

BP went up on the combo, but started with both drugs at same time; thus not sure which caused it. Extra Pred helped BP in conjunction with BP drug. I did not previously have hypertension. I have been able to slowly wean myself off the second dose of Pred without BP spike and am now on 5 mg daily. Seems that hot flashes are slightly better without the extra Pred. Definitely had the fragile skin issues with Prednisone and that was one reason that I wanted to get to 5mg. My regular doc said she would prefer that I take a higher dose of BP med than stay on more Pred, due to long term side effects.

[jackwfrench in reply to jmarsh]

Good to know as I have been on Valsartan for BP for years, am starting w 5mg Pred. Been trying to keep it lower with extra cardio work and diet.

[Professorgary in reply to jmarsh]

Research curcumin as well as magnesium for bp. Magnesium acts as a calcium channel blocker and curcumin relaxes the arteries as well as fighting Pca. My problem was I had hypertension that was managed with Lisinopril but adt caused a spike. Curcumin with black pepper for absorption and magnesium did the trick.

[Professorgary]

My biggest problem going on adt was bp. I had mild heat flashes and weight gain. I take curcumin and magnesium which lowered bp and helped with hot flashes. Just started Abi a few weeks ago with 5mg prednisone once daily and noticed hot flashes a little more but bp is good. As with all supplements have them cleared by your doctor. If you start to take curcumin and mg your bp may get too low. Both are good for the heart and if you google curcumin and Pca you will find some interesting reading. Also, 48% of Americans are magnesium deficient and one of the symptoms is muscle cramps.

[jackwfrench in reply to Professorgary]

I had been taking 500mg Tur/Cur prior to Lupron shot 4 wks ago and perhaps that's helped the hot flashes a bit. I also started black cohosh per MO last week and they are pretty gone. I am taking 1000mg Calcium per day and yet there is a point about not having enough Magnesium for your calcium. ncbi.nlm.nih.gov/pmc/articl...

I have Magnesium but not sure how much to take; difficult to manage all these imbalances!

[Professorgary in reply to jackwfrench]

I take a magnesium supplement called Magwell by Living Conscious. Capsule form so easily swallowed. 2 capsules contain 125% dv of D3, 54% of a combo of 3 types of magnesium and 68% of 2 types of zinc. I take 4 capsules daily. I have read it is hard to take too much mg because it is just passed through the kidneys. I also measure how much water I drink daily because when taking curcumin that is imperative because they contain oxcylates which can form kidney stones. I don’t take calcium supplements because I get plenty from vegetables and some from dairy and my calcium stays around 9.2 to 9.5.

[nextphase]

I've been on lupron now for three years. My psa has been at 0.02 for almost a year. Everyone's side effects are different. Body hair loss , loss of interest in sex,muscle loss and a little weight gain. The bottom line is to keep your self motivated and active. I myself try and work hard at staying active. I was first diagnosed in 2007 with prostate cancer. The best thing to do is go on living life like it doesn't exist. Good luck to you down the road it sounds like you're on top of things.

[jackwfrench in reply to nextphase]

SE is on my mind here and I am optimistic about it, however I have not reached "like it does not exist" because I keep reading about the relatively fast development of castrate resistence and the natural followup sequence. I suppose each person needs to develop their own comfort based on all they know and feel and make sure their affairs are in order for if and how fast it could go south. I do feel a bit better each time I run into a longer term survivor like yourself, thanks.

[treedown]

No additional side effects from Zytiga here either time I was on it. I cant say the same for Xtandi though. As others have said stay as active as you are able and try to push that limit for as long as able. The more active I am the less I feel like I am on drugs. That is until I go take a piss.

[Lunbo]

consider Prednisone to dampen the effects of both--worked for me!

[j-o-h-n]

On occasion Expect wise-ass comments from me...........So if you can't stand the heat then chalk up those flashes to Lupron............ Been on Lupron almost as long as since Harry met Sally......(15 years or so)...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/26/2023 7:37 PM DST

[Jake-82]

For me, the hot flashes became less over time. I have been on lupron for about ten years.. I started with monthly injections and now get one every six months. Now on Zometa infusion every three months along with Lupron. Doing well.

[jackwfrench in reply to Jake-82]

Good duration, curious, were you low volume disease, did you need or consider radiation?

[jackwfrench]

Thanks all for the great replies, this site is awesome!

I was getting a bit nervous about it because of articles like this -

mrcctu.ucl.ac.uk/news/news-...

Plus, it was looking like Abi did not really seem to enhance OS substantially. Jack