My father , 83 , recently got diagnosed with Prostate cancer with mets to some bones , as per PSMA test.
We have not done a biopsy as one doctor said there is no need to do it as treatment options won’t change but another doctor says it’s good to do it in case later down the line we need to add treatments.
He has been started on bicalutamide 100 mg a day for a few days and after around ten days he is supposed to get his first Lupron shot.
My question is does Lupron cause heart issues ? Would degarelix or relugolix be better choices ? We are also considering getting Orchiechtomy done but the doctor said to take the first
Lupron shot without delaying , and then after that we can think of the Orchiechtomy.
Dad is 83 and is in general good health and although he has not had heart issues yet , we have a family history of heart disease.
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"... Recent research has focused on the increased risk of CV events associated with ADT. Numerous studies have found increased incidence of myocardial infarction (MI), stroke, arrhythmia, hypertension, and sudden cardiac death (SCD) in men receiving ADT [4 , 5, 10]. Cardiovascular disease is already the second leading cause of death in men with prostate cancer. It is estimated that two-thirds of men with PCa are at increased risk for CVD [4 ]."
"... In 2006, Keating et al. were the first to publish data regarding an increased incidence of CVD and diabetes in men receiving ADT [24 ]. They conducted an observational study of 73,196 Medicare enrollees, aged 66 years or older, diagnosed with prostate cancer between 1992 and 1999. The study found GnRH agonists to be associated with an increased incidence of diabetes (HR, 1.44; p < 0.001), coronary heart disease (HR, 1.16; p < 0.001), myocardial infarction (HR, 1.11; p = 0.03), and sudden cardiac death (HR, 1.16; p = 0.004). These results demonstrated a need to further characterize the nature of the relationship between ADT and CVD as well as identify patients at high risk for these adverse events and develop strategies of prevention. Since 2006, many other studies have supported these initial findings. A 2015 study revealed a similarly increased risk of CVD in men receiving a GnRH agonist for treatment of prostate cancer (HR, 1.21; 95% CI, 1.18 to 1.25) [ 25]. Jespersen et al. conducted a national cohort study using the Danish Cancer Registry investigating the incidence of MI and stroke in men receiving ADT. The study found a significantly increased risk of MI (HR, 1.31; 95% CI, 1.16–1.49) and stroke (HR, 1.19; 95% CI, 1.06–1.35) in men receiving ADT [ 26 ] ..."
Excerpts from:
"Review of Cardiovascular Risk of Androgen Deprivation Therapy and the Influence of Race in Men with Prostate Cancer".
Lupron is poison…He will be miserable with the side effects…,Yes it does the job but the trade offs are not worth it IMO….Go the other way…..I’m 85 and have stopped it after 4 1/2 years….Quality of life is more important to me…,,
Why scare people like this because YOU have side effects? There are hundreds of men out there (including myself) who have very bearable side effects…….people like you were the reason I delayed getting ADT to my detriment……might have been cured early on had I done ADT with initial radiation……Consider that your words can have an impact but reflect the experiences of one person.
Everyone should do their own homework.,,my posts says IMO.,.and my opinion is Lupron is not a good trade off for what it does.., If it worked for you, great,,, There are other choices , and they should be considered..
My 71 year old husband has Eligard injections every 3 months (same as Lupron) and he has had zero side effects except for loss of libido, of course. But he also takes oral 1,000 mg Zytiga tablets (abiraterone) daily, along with prednisone. He’s been very fortunate to feel great. He’s only been on androgen deprivation therapy for 4-5 months. I’m hoping he will continue to respond favorably and that he stays castration sensitive for as long as possible.
I'm sorry to hear about your rough side effects. As I am another Lupron user, almost 2 years, my experience has been much better. A few hot flashes, reduced libido, but that's about it. I am able to exercise (weight bearing most days plus cardio) daily and I think that has made a big difference. And all my tests have been great so far so that is a positive obviously. But understand I am on the front side of my journey.
Thanks. Are the cardiac risks dependant on the length of time the lupron is taken Vs just taking it once ? Our doctor plans to give it once as does not want to delay treatment and after the one shot he plans to discuss orchiechtomy as dad is 83 and he thinks that may be a less tedious option for him.
I recently had a stroke after years on Lupron. My lipid panel came back just fine. I tried Pluvicto 3 cycles but the non PSMA PC took off on a feeding frenzy. So, I have to go back on Lupron or perhaps Firmagon, until next treatment options.
Here's a study by Kaiser Permanente. Being that I have/ had NO comorbidities at all prior to prostate cancer I had a discussion with KP a few weeks ago because their study shows an 81% increased risk of cardiac failure with adt.
I was told that the 5mg Cialis also helps with the heart being on adt.
The varying opinions expressed and cited 'papers' are good examples of the extreme disparities we face in battling this beast. Examples of the extreme range of SOC. As I share, for the past seven years I am doing all I can to defer ADT for as long as possible. My concerns for heart risks are one of the many reasons. My heart is very healthy and strong, excellent BP and pulse rate, no need for meds of any kind. All the best to all of us striving to make the right decisions - because the answers are not found in "SOC".
interested in anything anyone knows about the heart protective benefit of daily cialis and adt or if there are other factors to consider. Improved insulin use or fat gain??
My husband had his first Lupron shot in February 2005. He's been on it continuously for 19 years. His only side effects have been low platelets and high blood sugar. I guess a higher risk he worried about was of his cancer spreading.
interesting, and 19 years, excellent!! Question if I may, what is the justification for staying on ADT for 19 years - is there evidence it is still needed?
A few years ago, my husband delayed his Lupron shot by 2 extra months. His PSA and testosterone shot right up. Literature says that most men don't have their testosterone recover but leave it to my husband to defy the rules! Rather than risk it, he stays on Lupron. He's never had side effects except a sore tush for a day or two.
I suggest you research curcumin and magnesium for the heart. Then research curcumin for insulin resistance. Then research it for bp. Then research it for detoxing the liver. Then research it for balancing lipids. I’m tired of typing so I’ll stop but you get the picture. God bless.
Can't prove it, but before Lupron I had no cardiac symptoms, prior normal ECGs and treadmill, no risk factors, no family history (a brother from unrelated death had 'clean coronaries' on autopsy). Ten months into Lupron, (no other meds,) I developed increasing angina, multifocal coronary calcifications and distal stenoses on angio. Because of associated sarcopenia and negative PSA we decided to hold Lupron. So, yes I would consider Lupron a probable suspect.
My husband was diagnosed at 62 at stage 4 in 2014. He was receiving Lupron shots every 6 months for 5 years. In those years he had 4 heart attacks and those attacks occurred within a few weeks of receiving the shot. The oncologist was very reluctant to say it was from the Lupron and it was only after the 4th that he was taken off. It took a year for his psa to rise and the Mets returned and he was then given radiation twice. In the meantime, Orgovyx became available and he has taken it for almost 2 years. His arteries are very calcified and I pray everyday. I would have never believed he would still be with us after all this. Thank God for a wonderful doctors. I combed the internet trying to find the correlation but there was very little to support it. I am glad this is finally coming to light.
My god. 4 heart attacks. Did it happen after the first shot or after a few ? Btw for artery calcifications I have been giving my parents , vitamin k2 drops from Thorne products. Vitamin k2 in the mk4 form has been shown to reverse calcifications in Japanese trials
Orgovyx is worth considering as a less-stressful oral alternative to Lupron. I too had a heart attack while on Lupron, but upon emphasizing exercise and attentiveness to heart concerns, have been fine for 2 years now on Orgovyx.
I had been getting the Lupron monthly for almost an entire year, and since I was on a doublet therapy, I don’t blame the Lupron by itself. But over time there does seem to be some evidence (as of yet unproven) that instead of agonists like Lupron, so-called antigens like Orgovyx are better for the heart (and since a daily oral pill, easier to pause if need be).
My husband is on a Doublet therapy. Oral Zytiga and prednisone plus Eligard injections every 3 months. When chemotherapy such as docetaxel is added then it’s called Triplet therapy.
I’m not the best qualified layman to accurate reply, but I’m on relugolix (brand name Orgovyx) AND Apalutamide (Erleada), the latter of which is one of several secondary kinds of meds that complement the main anti-androgen med. When one is found to be metastatic but hormone sensitive and healthy enough to handle it, it is increasingly recommended to hit it hard early- even with triplet therapy, which includes a type of chemo too.
I am sorry to hear about your Dad My dad was diagnosed with stage 4 mets to 8+ bones at 79, and we are currently 18+ months into his disease. We started with the same two meds your dad is on. My dad had a heart attack 20 years ago and has a stent. Two other arteries were 40% blocked at the time. He currently still smokes. He has never had high blood pressure but adt has increased his blood pressure and is now on Lisinopril. My father's cancer has advanced over the last 18 months. I can see on the PETSM mention of blockages in his heart but have not pushed visiting a cardiologist because at this point a heart attack would be so much better than watching his cancer. With that said I had suggested several times months ago about going to a cardiologist which he declined.
My dad was diagnosed at stage 4 without biopsy as well. Feel free to message me if you want to talk further.
I’m not knowledgeable in the other drugs, but anything but Lupron would be better IMO..,His oncologist should have other options…If he doesn’t find another Dr that specializes in PC …Google horror stories with Lupron…I’m metastatic , I’ve done chemo,, proton beam therapy, BAT, and now looking at Pluvicto…So I’m in a different category….
Debatable, while I’m glad your side effects are mild there are people suffering 4 heart attacks after getting on lupron when they were heart healthy before starting. There are so many men and now I found out women that had debilitating side effects that almost killed them and I’m sure has killed them when they started the lupron
i agree with the recommendations to use an alternative to Lupron ... a great resource book on ADT is "Androgen Deprivation Therapy: An Essential Guide For Prostate Cancer Patients And Their Loved Ones" by Wassersug, Walker, and Robinson ... ADT has many potentially serious side-effects ... imo, those on ADT should be doing things to prevent those side-effects becoming reality 😀
I did adt for a total of seven months n after 1 month of lupron switched to orgavix. Felt a little better, a lot less winded and heart in general felt better as well. I’m 59 and after 7 months I got rid of all adt and went with ivermectin cbd oil and turmeric and have had pretty good success thus far. It’s been over a year and psa has declined consistently from 1.95 to .75 and now has stabilized. There are other options n routes to look into. I went the ivermectin route when I found nih n pub med articles stating that they were looking to repurpose ivermectin as a possible pca treatment. I wasn’t about to wait ten years for clinical trials to take place and started using it immediately as it had been widely used billions of times w virtually no side effects compared to adt. Some people use fenbendadozole and other anti parasitic/anti viral drugs with great histories and tolerance. Good luck n def food for thought but imo def would not use lupron…
Good to hear someone else dumped the adt and went natural. Diagnosed April 2020, did radiation and two 3 month shot and one 6 month shot. Couldn’t do it anymore, I think every side effect there was I had. I still have side effects after 3 years of not being on adt. I too went the ivermectin route and turmeric. I probably need to add the CBD oil for the residual joint pain from the adt. PSA has been steady since.
Wow that’s great news, if people continue to hear these success stories then they may be willing to look at safer alternatives. ADT was just ridiculous for me as I felt it was killing me faster than the cancer, not to mention I believe ivermectin actually kills the cancer where the adt just suppresses it and makes it more virulent when it comes back after two years…
Agreed....sometimes with some people the cure is worse than the disease. I've been able to tolerate many things in my life but this is one that I could not. While on the ADT I had no life at all, my body was wasting away. Now I have lingering side effects but I can manage. I am much happier. Hoping at some point we here more about ivermection and other drugs that are less harmful.
Yes dogs usually take 3mg and humans can take .4 mg per kg of weight for example 100 kg is 220 lbs, hence 40mg/day is tolerated pretty well. I personally now take 12 mg/day twice a week mon/thur but initially took 40mg/4x week the first week n then weaned to current dosage. Hope this helps
Men receiving Lupron Depot are at increased risk of cardiovascular disease including myocardial infarction, sudden cardiac death, and stroke. Monitor for signs and symptoms of cardiovascular disease.
Androgen deprivation therapy may prolong the QT/QTc interval. Correct electrolyte abnormalities before treatment and weigh up the risk vs benefits of Lupron Depot in men at higher risk for QT interval prolongation, such as those with congenital long QT syndrome, congestive heart failure, frequent electrolyte abnormalities, and taking other medications known to also prolong the QT
Lupron Depot may increase your risk for cardiovascular disease, including an increased risk of a heart attack. If you experience any chest pain or pain that radiates down your arm or up your neck, seek urgent medical attention.
I have been on lupron for 2 years and started on Casodex for two weeks before my first Lupron injection. I have very mild side effects and live a great life for guy soon to be 74. Psa 5664 down to 1. Horrific pain gone. Hunt, fish and do the wife’s honey do list. Now the downside, I get the one month because my brother got his first shot which was a 3 month and had a fatal heart attack 2 days later. He however was not given bicalutimide to buffer the testosterone flare. Best wishes and God bless.
Wow that’s the scary part n so sorry to hear about your brother, it’s remarkable your doing so well w so little side effects. Also agree on 1 month shot as opposed to three or six n didn’t realize the bicalutamide could buffer n maybe prevent heart attacks. But it’s rolling the dice w lupron imo…
Yeah when I got the first shot after the first week or two, I was thinking wow this is not that bad after all n then the third week hit n all of a sudden had the hot flashes, mood swings everyday felt like my body was wasting away, didn’t have any desire to do much, had to force myself to surf n throw football not to mention started to get flabby n craving junk food. Skin started to get soft like a women’s, but the weird thing was I had no body odor at all, especially under my arms, so that was probably the only good thing that came out of it…😂
I am so sorry to hear about your brother. Efficacy wise are the one month shots and 3 months equal ? I wonder why all men are not prescribed the one month shots. Did you have bone met pain
I believe efficacy wise 1 and 3 month have equal efficacy but 3 month is more convenient. I just discussed having an orchiectomy today with my urologist. I will see him again in 6 months and set a date for surgery if I still feel like I want to go that route.
There is a reason they tell folks to exercise, maintain a decent diet, limit alcohol, and have regular cardiologist visits while on Lupron. I’m pushing 4 years now, have cardiologist visits every 6 months, and eat well “most of the time”. Come on folks, take some responsibility for your own health to try and help yourselves a bit with this beast we are dealing with.
OK, I just put on my flame retardant NOMEX old flight suite on so I am ready for the blow back so here goes. There is a 500 pound gorilla that seems to underlie many discussions on forums like this. Fear of dieing.
First I totally agree with Ingress and will add something my mom taught me. “God helps those who help themselves”.
Second, let’s get real we are all going to die. After 70 our days are really numbered. I have an aunt who is 96 and honestly she is just waiting to die and has been for many years. Her QOL is totally gone. I have to ask myself do I want that to be me?
Third, I have lived an amazing life and my immediate family is doing well. My kids and their kids are on a good path in life. What more can I ask for?
Hanging around just to be alive may not be in anyone’s best interest. I agree that it is much easier to write this at almost 80 than at 50 when my family was younger and needed my support.
I learned a long time ago in a far off land that once you accepted you could die the better you could do your job and the fear of death was gone.
I am on Orgovyx and Nubeqa no known side effects 4mo in. Many folks also having good results. Insurance drug coverage can be big concern. But there are ways around the cost co pay cards, grants, etc. Lets face it Lowering T count has it's own problems but that's the objective with these meds and they lower psa . Always a trade off at times. Best
Had open heart surgery in 2022 and diagnosed with PC 3 months later. Doctor told me after radiation he would put me on Orgovyx because of my heart. Just got off of it in May after 2 years on it. My results so far have been excellent! Only side effect has been hot flashes. Wish your father the best!
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Casodex and Lupron
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Lupron shot
