Lupron - start with one month dose or 3 months ?

[Tinkudi]

Dad , 83 , is to start with lupron soon. He has been on bicalutamide since two weeks.

He is in good health generally and has not had heart issues apart from hypertension since many years , controlled by medicine.

Doctor has advised 3 monthly lupron injections. But I was wondering if it would be wiser to start with the 1 month dose instead to see how he does on it ?

Also , I have been reading that antagonists like Degarelix or relugolix may be safer from cardiac safety point compared to agonists like lupron ?

Any thoughts and experiences which can be shared ? 🙏🏻

[Tall_Allen]

So, you are willing to neglect his doctor's wishes on this, but not on an unnecessary biopsy?

[Tinkudi in reply to Tall_Allen]

Hi Allen ,

The doctors said we won’t start treatment without the biopsy. I am helpless. I really tried a lot and met 5 different doctors. 🥲

Regarding this ADT question , they don’t seem rigid on the options. Hence , I am asking. Will be grateful for your input 🙏🏻

[Tall_Allen in reply to Tinkudi]

That’s not what you wrote before. I can only help those who are honest with me.

[Tinkudi in reply to Tall_Allen]

Allen , I respect you a lot and am grateful for your help. Why would I lie ?

All the medical oncologists I consulted said first biopsy and only then treatment.

One surgical uro-oncologist who has trained at Cleveland clinic did say that we don’t need to biopsy but dad was not comfortable with his bedside manner as he seemed too eager to tell life expectancy etc which made him very uncomfortable. He also said that he will make us sign a document saying we were ok getting treated without a biopsy and would not blame him later.

Since we thought, going forward , dad would require a medical oncologist and not a surgical one , we had to submit to the medical oncologists.

Did not say so much in detail earlier as it gets too lengthy.

I am trying my best to do the best for my dear father and again I greatly greatly value your help. God knows I tried extremely hard to convince the medical oncologists otherwise.

Please do not misunderstand me. I need you 🙏🏻

[Tall_Allen in reply to Tinkudi]

If your doctor's in India refuse to follow patient's wishes, you don't have choices.

[Tinkudi in reply to Tall_Allen]

They were flexible on the choice of injection, though they seem to lean towards lupron. But when I mentioned Degarelix they said that can be given too. Relugolix they seemed to be not so sure about

[Tall_Allen in reply to Tinkudi]

It doesn't matter.

[Tinkudi in reply to Tall_Allen]

Thanks. Do you mean either of the injections is ok ?

[Tall_Allen in reply to Tinkudi]

They are all equivalent.

[Tinkudi in reply to Tall_Allen]

Allen , for the first time does it make sense to take one month dose then instead of 3 months dose to see how he reacts to it ?

[Tall_Allen in reply to Tinkudi]

It doesn't make sense to me. Lupron is one of the longest used medicines, and has a good safety record.

[Oatmeal2]

When my husband started ADT, the plan was to give him Degarelix for the first injection because it is superior to lupron in dropping PSA more quickly and you don’t have to take the bicalutamide pills prior to injection to prevent the testosterone flare. After the initial injection, the plan was to do 3 month injections of Lupron. However, after the first Degarelix injection my husband felt well with minimal side effects, so he asked the oncologist what was the reason for switching to the 3 month lupron since the drugs were equivalent and the Degarelix seems to have less overall side effects. We were told it’s really more about convenience and we later found out, cost had something to do with it. So he decided to stay with the Degarelix and so far, after 10 injections he has tolerated the drug very well. It is a little more inconvenient to go every month but not a big issue. If you feel you want to start your father on a one month dose, instead of a 3 month dose, then in my opinion, try it out.

[Tinkudi in reply to Oatmeal2]

Thank you 😊 What was his diagnosis. Did he have bone mets ?

[Oatmeal2]

He was Gleason 9 with spread to one pelvic lymph node but no other spread per the PSMA scan. He did 26 rounds of radiation and is getting monthly Degarelix injections.

[Tinkudi in reply to Oatmeal2]

I wish you’ll continued good luck 🙏🏻😊

[Mgtd]

Not sure this will help since I am a study of one. I am the sole caregiver for my handicapped wife and I was concerned about the effect of ADT on my ability to care for her, etc. So I asked for a one month shot of Lupron after two weeks of Casodex to start with. This was to stop the initial flare of Lupron.

Well the PA gave me the wrong dose. She gave me a three month shot. For me it was upsetting but honestly I had no issues other than the normal stuff.

Now off Lupron and recovery of testosterone was really quick. I am enjoying life.

The key to side effect reduction is exercise - resistance and aerobics.

[Tinkudi]

thank you 🤗🙏🏻

[Professorgary]

God Bless.

One month Lupron. Abiraterone added after 15 months.

[Tinkudi in reply to Professorgary]

Thanks. So what’s the one month dose you take monthly ? Any side effects ? Did the doctor offer you the one month dose or you asked for it

[Professorgary in reply to Tinkudi]

It’s 7.5ml here in the states. I asked for it because my brother died of a heart attack two days after a 3 month Lupron shot. He did not however have the bicalutimide to protect from the spike in testosterone. Larry was 74 years old and very active with no history of heart problems. As far as side effects, libido is minus 5 lol. A few minor hot flashes but great energy, no pain, very minor weight gain, less than 10 pounds in 2 years. Good muscle mass and bone density. I do take 2800 of Swanson curcumin complex and 400 mg of magnesium. I do not take calcium. I encourage you to google curcumin and every side effect listed for ADT and you will soon see why I take it. Also if your dad is taking nsaids for pain I suggest you talk to your doctor about switching over to Celebrex. It does not block the cox 1 enzyme like the others. The cox 1 enzyme protects the gastric tract. Also google curcumin and magnesium to protect the heart. I pray quite a bit and never asked God to cure me. I asked for wisdom. Wisdom is needed to make the desisions that we face in this battle. I wish you and your father the very best. I think he is a very fortunate man to have you to help navigate. And please remember, if in doubt, ask for a second opinion. God bless.

[Tinkudi in reply to Professorgary]

Thank you very much. God bless you too. 🤗🙏🏻

[Professorgary in reply to Tinkudi]

So sorry, I didn’t specify the drug I take. It is Lupron.

[j-o-h-n]

Doctor has advised 3 monthly lupron injections.

I'm confused as usual.... Please explain the frequency of the Lupron injection(s)? Use examples if need be....

Regards to Dad...

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tinkudi in reply to j-o-h-n]

Hi John 😊

Doctor said to take the lupron once in 3 months which is a bigger dose compared to the once a month lupron dose.

I see some over here say they had lesser side effects with once a month dose

[j-o-h-n]

I've taken Lupron every 3 months (in fact one coming up this Monday 6/3/2024) for 15 years and I'm not complaining and I'm 4 years older than your Dad. I take it in my left buttocks. But all of us are individuals and we act/react the same or differently. So, keep up the good fight...

p.s. I never tell the Juite (Hindi spelled phonectically).....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tinkudi in reply to j-o-h-n]

😀 where did you learn Hindi

You seem to have experienced minimal side effects with the lupron

[j-o-h-n]

That's right and I was also taking Casodex (replaced by Nubeqa in April 2023). I really don't know if my side effects were from either or both meds. But those s.e. were negligible, and are the usual suspects.

Did you understand my Hindi? Well I learned it from a woman who once was my "Mehabooba" who taught me the difference between the "ALM (mango)" and "EMALY" ( tamarind seeds)".

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tinkudi in reply to j-o-h-n]

😊😊😊 God bless you dear John