Gynecomastia while using the various "mides."

[dhccpa]

I've gathered over time that using any of the "mides" (bicalutamide, enzalutamide, apalutamide, darolutamide, also known as Casodex, Xtandi, Erleada, Nubeqa) can cause gynecomastia, or breast enlargement.

Have any of you using one or more of these drugs had that happen? Have any of you not had it happen after a year or more of usage?

If you have had it happen, how soon did it appear?

Did you use any preventative treatment, such as Tamoxifen or chest radiation? Did you do or start it before using the "mides" or after noticing breast growth?

Thanks. Any other details you care to offer will be helpful.

I haven't used any of those drugs yet myself, but it's very possible I will in the not too distant future.

[Tall_Allen]

Usually not a problem if combined with ADT.

[dhccpa in reply to Tall_Allen]

Thanks. I wondered about that since estrogen would be low (and I tested mine recently-it was undetectable), but didn't know one way or the other.

[janebob99 in reply to dhccpa]

Having an undetectable estradiol makes you more prone to hot flashes, osteoporosis, elevated blood sugar, and increased bad cholesterol. You may want to consider adding some supplemental estradiol to combat these side effects.

[dhccpa in reply to janebob99]

Yes, I've been trying to talk my docs into it, but they seem very nervous about it. I suspect they're the rule, not the exception. But I'm still working on them

[janebob99 in reply to dhccpa]

Understood.

Perhaps talk to your PCP instead, and pitch it as a way to increase your bone mineral density and reduce hot flashes...not cure cancer.

[dhccpa in reply to janebob99]

I'll try that. I see him week after next. MO and RO next week

[Justfor_]

I started Tamoxifen from day one with Bicalutamide. As I was lowering the Bicalutamide dose I tried unsuccessfully 4 times to lower the Tamoxifen dose. Within one week I felt tenderness in my breasts and aborted the reduction. On the 5th try I got lucky and currently it is 10mg the day I take the 25 mg of Bicalutamide and 5mg/day the following 3 of my 5 day cycle. Nonetheless, in proportion to Bicalutamide the Tamoxifen dose reduction is way less permitting.

[dhccpa in reply to Justfor_]

Thanks. I see more mention of gynecomastia with bicalutamide, as opposed to enzalutamide. Do you think that's because most men on enzalutamide are also on ADT, whereas most on bicalutamide are not?

[Justfor_ in reply to dhccpa]

Very plausible assumption.

[Ian99]

I took Bicalutamide for several years. Dosage 150mg daily with Tamoxifen (1/2 20mg tablet per week). Tenderness reduced gradually.

[dhccpa in reply to Ian99]

Did you start Tamoxifen before or some time after you started bicalutamide? Or at same time.

[Ian99]

Some time after. I was unaware of SEs at the outset.

[Gabby643]

Lupron and 120 mgs. Of Erleada for 5years and I missed radiating or Tamoxifin. Size C cup of 12year old. The MO’s are far and few here in the Aloha State. Ehhh. I’m alive!

[gsun]

I have not heard of this before. Only when taking estrogen of some sort. I have been taking Enzalutimide for a month now and will bring this up at my next appointment. Anybody have this issue with Enza?

[dhccpa in reply to gsun]

TA replied that ADT normally prevents it, but someone else responded that on ADT plus Erleada he had it happen.

[tarhoosier]

In my extended history I had gynecomastia, later treated with surgery, which can be done again. Due to that experience when I started mono therapy with enzalutimide I anticipated some breast growth and it occurred. A year ago I had the choice to stop all Enza for a period and to monitor my progress. When inevitable rise came I could restart enza. I decided the single side effect I wished to limit was gyna- and so I reduced my dose from four/day to one/day rather than zero/day. My reduction to 1/day had no noticeable reduction in fatigue or any other latent side effect. Now on 3/day to maintain <0.1.

It is rare to have the option of which side effect one wishes to endure. This was my choice.

[dhccpa in reply to tarhoosier]

Thanks. There's certainly a lot of issues we have to deal with.