Dad , 83 , got diagnosed last month with bone mets and psa 18. The urologist started him on Casodex 100 mg to take daily and then take a lupron shot after 2-3 weeks.
Before starting the Casodex he had bone pain in a femur and was taking Ibuprofen sometimes but since starting the Casodex since the last 18 days he says the pain is much better and has not needed any medicine.
We consulted a MO then , thinking that in future what we would need is a MO and not a urologist. He just dismissed the Casodex and said it’s of no use and can just stop taking it and wrote a prescription for Eligard which dad will take day after Tomorrow.
My question is , is it a problem continuing Casodex also after taking the eligard shot ? I thought casodex is given to prevent the testosterone flare as it helps reduce testosterone but I see some comments on this forum saying it can over time turn into feeding the cancer ????
Any thoughts or experiences on this ?
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Tinkudi
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You do not need to take Casodex in combination with Lupron, it will have almost no effect. You just take it for one or two weeks before starting with Lupron. Your dad should take Abiraterone or Enzalutamide in combination with Lupron instead.
Hello, your Dad needs to take Casodex until the Urologist tells him different. As Magnus has said it is a mild ADT drug, I was on it for a while until it stopped working, it is used along with Lupron. If you look it up online it will explain better what it does.
The urologist should be monitoring it for you, my own experience of it was my PSA began to rise again, so it was time to change the treatment. I hope that helps you.
Along with Lupron, I wasn't on it very long, I can't remember exactly. Eventually I went onto Zytiga, Prednisone and Lupron. That was about 5 years ago, maybe more.
Do not rely on the results a few men report here...or anywhere!!! Doctors don't!! Use Google or pubmed and find well done studies that discuss results with Casodex only, Lupron-type ADT only, and ,most importantly perhaps, combination treatments. Maybe you can find a great MO who will provide you with such facts? Or a urologist with deep PCa background? Generally, it is MOs who help with treatment for metastatic patients.
Remember, by taking ADT drugs you are trying to LIVE with your prostate cancer not KILL it. So more drugs are not the goal. The goal is to find the dose that keeps your PSA at bay for as long as possible.I have been extremely fortunate. When I Started ADT drugs casodex was the only starting drug. When it failed 5 years later zytiga trials were starting. This progression of new drugs continued to stronger and stronger drugs with different approaches to testosterone suppression.
When I was first diagnosed G9 I was told that Casodex was taken for a month before Lupron to prevent psa flaring up. Then after starting Lupron to stop taking Casodex. Definitely work with an MO given there are mets. Urologist is not skilled with mets.
Casodex is misunderstood in SOME cases as to what it can do and what purpose it should serve.
I am NOT advocating that anyone do what I have done - but here's something you might not be aware of.
SOME of us can use it DAILY for extended periods of time without going the ELIGARD route, which has some very unpleasant side effects that many cannot tolerate easily.
I've had PCa (diagnosed 8+ years ago) which included a recurrence AFTER using ELIGARD for nearly 2 years. I also had the MAXIMUM radiation dose that they told me they could use in the pelvic area and some hot spots (nodes).
I took a treatment 'holiday' which lasted about 18 months - then the scans and PSA tests had me back in the 'game' of deciding what I could do.
I CHOSE Casodex 'monotherapy' - 150 mg DAILY - and continue to this day - about 3 years later, where I REMAINED undetectable.
In the last year, I have slowly started to have an elevated PSA count. I am increasing at a rate of about 25% every 3 months - I'm was at 1.7 about2 months ago and will be tested in another 30 days.
I have had some 'small' bone lesions and was node positive from day 1.
I actually had some 'recession' where everything that had been noticeable was GONE, while using just the Casodex.
Nothing is showing up on any scans and Casodex allows you to maintain a 'normal' level of testosterone.
In addition, I have NO side effects - other than periods of fatigue. I have regained weight, muscle mass and good eating and sleeping habits.
NO HOT FLASHES !
My plan is to do NOTHING !!
I'll let the PSA rise MUCH higher, because PSA is a flag / marker BUT it doesn't give a complete picture of what is really happening.
I MIGHT quit the Casodex completely IF something triggers a runaway condition.
I have agreed to do SPOT radiation IF / WHEN they actually FIND the source.
I've met men with elevated PSA, who did nothing for years and were doing quite well considering.
I've been advised that elevated PSA could be a good choice, considering the alternatives.
Quality of LIFE is more important to me than how long I'm willing to live a life that has 'passed' it's best before date.
I have elected to discontinue Lupron due to the side effects and do bipolar androgen therapy with Casodex. I will only take Casodex on the onset of bone pain for about 4 days and then I am off for about 6 weeks. Then the pain seams to return. I dont wish to live testosterone free because my energy level tanks and I feel depressed. ( among other Lupron side effects) I keep my improved diet and exercise in addition to this routine and things seem to work for me.
Not exactly... Urologist put me on Casodex to prep me for Lupron by my Oncologist. Lupron has a tendency to give a high flair of testosterone when first injected. This can cause high bone pain. By taking Casodex first and until you get the Lupron shot it can mitigate the flair by blocking the testosterone temporarily. Normally you just stop Casodex after a few weeks of your Lupron shot. I took the 6 month shot and decided not to continue with Lupron. At about 11 months the pain returned in a bone flair so I took the Casodex and the pain went away after about 4 days. Hope that is clear
My husband, age 71 was diagnosed with Stage 4, advanced metastatic PC, Gleason 9 in November. Initially his urologist put him on Casodex and he had one Eligard injection. He said that once he meets with a medical oncologist, he would be put on a 2nd generation hormone drug. He was put on abiraterone (Zytiga) and discontinued the Casodex. Still has an Eligard injection every 3 months. He completed 28 IMRT radiation treatments and right now his PSA is undetectable.
It should be illegal to give guys Lupron after 70. Since your in India DM me and I will give you the best medicine and natural supplement take that will lower the PSA 80% in less than a month.
Hi Tinkudi. You need a good MO who specialises in PC for your father. I am from Gurgaon and have been fighting this beast successfully for the last 14 years.
casodex is usually used at first to prevent a flare from lupron or eligard then discontinued, the bone pain and bone mets they can give a shot xgeva and that will help there. After my father who was 83 at diagnosis started failing lupron alone, he then threw the casodex back in and it worked in combination at that time for 18 months so they like to not run it out at first and put it away for later, this is how his oncologist explained it.
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