Casodex(tablet) Vs lupron(injection)

[Mrtroxely]

Hi allCasodex (bicalutamide) 57% for driving down PSA

Lupron 87%

BUT........

maybe for an individual would it be worth trying to see if casodex tablets worked better for driving down PSA instead of the lupron injection????

[Justfor_]

In my case, Bicalutamide is 10 times more than enough. I see you are in the UK and have read horror stories from there i.e. prescribing 150 mg/day monotherapy. For me 150 mg are good for a whole month! If you haven't seen my relevant and monthly updated thread, it may be worth a visit:

healthunlocked.com/prostate...

[Mrtroxely in reply to Justfor_]

I'll look overLooks very interesting

Thank you

[MoonRocket]

Are you asking about mono casodex instead of ADT? If so, I suggest you research mono enzalutimide if you want to attempt getting off the ADT. It's only approved for nmHSPCA, but if you are mHSPCA and looking for relief from ADT, it might also be effective.

If you are determined to use a anti androgen like casodex or enzalutimide, you'll want to to do something about the potential gynocamastia.

I got my chest irradiated to prevent the gynocamastia.

[SViking in reply to MoonRocket]

was the chest radiation in itself effective?

[Grandpa4 in reply to SViking]

I did this too. The radiation is with electrons. Not gamma radiation. No side effects. It is supposed to be very effective. I worked for me

[MoonRocket in reply to SViking]

So far it's been effective. I had it done before starting the enzalutimide.

[GP24]

Casodex 150 mg is almost as effecive as Lupron. It does not lower testosterone and therefore has fewer side effects. However, with a Gleason 9 I would use Enzalutamide monotherapy according to the EMBARK study: urotoday.com/conference-hig...

[street-air in reply to GP24]

is this study, the EMBARK study, the current best treatment option for high risk small recurrence after RP no mets visible, people? the doublet drug for two years then cease and wait, no additional pelvic radiation nor chemo?

[GP24 in reply to street-air]

Mrtroxely asked if he could use Bicalutamide instead of Lupron to avoid side effects. Enzalutamide is more effective than Bicalutamide and therefore I would recommend that for a Gleason 9. The Embark study used intermittent ADT. So if the patient reached a PSA value of below 0.2 ng/ml after36 weeks, there was an ADT holiday. Also Enzalutamide monotherapy was more effective than Lupron monotherapy.

I cannot say if this is the best of all possible treatments. But the study showed very good results.

[Magnus1964]

I have always found starting with a milder ADT, low dose, is best. You can always stop and move on to a stronger drug.

[RWRB in reply to Magnus1964]

I had no choice in the does from my Oncologist. Abiraterone Acetate 250mg each 4 nightly.

[Magnus1964 in reply to RWRB]

That is a huge dose of casodex. I was on 50mg daily.

[RWRB in reply to Magnus1964]

I was offered a choice of dose. I have documented all my blood test results of psa and testosterone.

Next month visit getting off will be discussed.

[RWRB in reply to RWRB]

Oops Not a choice of dose

[Magnus1964 in reply to RWRB]

You always have a choice unless you are in a drug trial.

[RWRB in reply to Magnus1964]

Maybe you have but I have not

[Magnus1964 in reply to RWRB]

You can insist on a lower dose, or find a new oncologist. I would put this oncologist's feet to the fire on this. Ask why the casodex is being dispensed in this manor. It is your right to know.

[Tall_Allen]

PSA is not prostate cancer. Weak antiandrogens like Casodex has been compared to ADT in many trials. In a meta-analysis, the authors conclude:

"Currently available evidence suggests that use of non-steroidal antiandrogen monotherapy compared with medical or surgical castration monotherapy for advanced prostate cancer is less effective in terms of overall survival, clinical progression, treatment failure and treatment discontinuation due to adverse events."

pubmed.ncbi.nlm.nih.gov/249...

PSA suppression occurs either way, but it lasts longer and one lives longer when one uses ADT.

[Mrtroxely in reply to Tall_Allen]

I read lots of study's and papersAnd the stats.

I had short course of casodex before the lupron injection

That drove PSA below 0.1

I've been on lupron since and those numbers slowly creep up

Last PSA was 0.44, waiting for next blood test to see if it's doubling.

But in the studies don't show if any individuals had a better result, it takes the average?

Just thinking out loud before I talk to oncologist again next month

👍

[Tall_Allen in reply to Mrtroxely]

A "short course of Casodex" is almost always prescribed before Lupron. The reason is that Lupron always creates an initial surge of testosterone that can activate the androgen receptor (AR) on the cancer cells. A short course of Casodex prevents the AR activation.

[Justfor_]

From the classic US discography:

Hey, Rosita come quick,

down at the cantina they injecting Lupron with tequila

[MarkBC]

I was on ADT for about 3.5 years when my PSA started to rise above 1.0. My oncologist added bicalutamide saying that it sometimes helps extend the effectiveness of the ADT for a few months. For me, it dropped my PSA back down to undetectable levels for over a year before it rose to 1.0 again and I was declared castration resistant.

[Tinkudi in reply to MarkBC]

You had not taken bicalutamide before starting ADT ?

[MarkBC in reply to Tinkudi]

No.

[SteveTheJ]

I'm not sure the details of your case but my initial therapy was bicaludimide and Lupron.

[Tinkudi in reply to SteveTheJ]

How many days did you take the bica

[SteveTheJ in reply to Tinkudi]

I don't remember exactly but the stage 4 diagnosis was about April 9, 2020 and I took it from then until I got my first Rx for Erleada from MD Anderson in May. So about a month.

[PELHA]

Husband was on that for several months as a mono treatment but then PSA started to rise so was switched to quarterly Lupron. Someone here did post a study that showed that is what typically does happen.