How much can casodex 50 mg a day lower psa if you take it for 2 weeks ? Anyone know ?
Psa levels and casodex: How much can... - Advanced Prostate...
Psa levels and casodex
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palser1
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The purpose of taking it for 2 weeks before starting Lupron is to prevent the effects of the initial testosterone surge you get when you start Lupron. Its effect on PSA is immaterial.
I understand that , I was just wondering why the psa level has gone from 120 to 35 and was it due to the casodex or something else . As he still hasn’t been diagnosed yet ? And has it happened to anyone else .?
Yes. It reduces PSA. That’s what it does.
Ok thanks
FWIW, 120 to 35 in two weeks is about as fast as PSA can drop. When men have their prostate removed surgically, which should in theory drive PSA to 0 instantly, it still takes multiple weeks for the body to clear PSA from the bloodstream.
Right , I thought it was really quick after reading everything on the internet .
Do you know why it would happen that quick ?
Don't know why it drops that quickly but sometimes it does. What matters most is how low it drops IMHO.
Well he is having a biopsy next week to see if it is prostate cancer we know it probably is with a psa of 122 it’s just how bad it is .
Hey palser1!
An in bore, real time, mp 3.0T MRI by someone with experience is the biopsy he should have. That gives the best imaging possible and reduces the number of cores that will need to be taken. This, the best "reconnaissance" of the enemy, will help in choosing treatment options with durable results. Many of these biopsies are a "shotgun" type, the "I'm not sure so let's biopsy everything". Swiss cheese!
The fluoroquinolones commonly used, Cipro and Levaquin have received much more stringent warnings from the FDA in recent years, including doubling the incidence of aortic aneurysms in those whose doctors have prescribed fluoroquinolones for to prevent sepsis from biopsy procedures. The fluoros can also harm joints, ligaments and tendons literally crippling a patient. Insist on Rocephin or Cefdinir rather than a fluoro.
A trans perineal biopsy is another option where the needle gun isn't inserted in the colon thus avoiding transferring feces into tissue. This biopsy also provides better access to some areas of the prostate that can be missed with the other biopsy.
Currumpaw
I hope he had the bone scan before PSA dropped.
Finally got him in to a specialist cancer hospital and seeing a prostate specialist who said biopsy first then PSMA scan . Said he looked at his mri and ct and they want to do that first and wanted to know more about mesh in his abdomen from hernia op . I have no idea why .
No bone scan before the drop we just stopped taking it . When you said he should stop . Then explained everything to the new guy once he read all his reports he was shocked he had only had one psa test .
I did not say a PSMA scan - that would be ridiculous as a first scan. I don't know how to make this more clear - you keep misunderstanding me. I said a BONE SCAN. The Bone scan should have been done before a biopsy and before he started taking Casodex. We seem to be unable to communicate so I will no longer respond to you.
I know you never said that . I can hear you . But we are not in America like you or in the United Kingdom we are in Dubai . I said before, we found out all this 3 weeks ago . And don’t know which way to turn to be honest you are saying one thing the doctors are saying another . I’m sure when you first found out about all this you were in a tail spin . I’m not deliberately being dense you said stop casodex we stopped it . We just thought the PSMA test was better as it detected smaller cells . If you don’t want to respond that’s fine thank you for your support and understanding up till now
As I said before he has had a an ultrasound , a CT scan and an MRI scan so not his first scan at all the only one he hasn’t had yet is a bone scan
Yet a bone scan could've ruled out a biopsy, as I've said repeatedly. I don't envy the third-world care you are getting in Dubai. I think anything I advise will only increase your frustration. Why seek out advice from others if there's nothing you can do about it?
It's pretty amazing to me that you can get something as sophisticated as a PSMA PET scan but you couldn't get something as simple and basic as a bone scan. The doctors there seem to have the best toys but don't know how to use them.
Well my urologist has only been here a year he came from Sweden where he was doing studies on prostate cancer and is now opening a specialist hospital for prostate cancer alone . We will speak to him again regarding the bone scan . But my brother had prostate cancer 6 years ago and he had a biopsy first in the uk maybe it’s what do outside the us I don’t know ive never been in this situation before , and I’m not only here for advise I’m here fora bit of support it’s not frustration I feel it’s terror I’m afraid .
But your brother didn't have a PSA of 120. Bone scans are the first diagnostic test that should be done with a PSA that high. It could have spared him an intrusive biopsy that might even spread the cancer. Bone scans are often overused in men who really don't need them - but not in this case.
brothers psa level was 90 so no not quite as high .john has not had the biopsy yet but when we raised the subject with the urologist he said we will still have to do a biopsy . Look I understand you have been in all this for a very long time and people speak so highly of the advise you give but this is so new to us . It’s hard when you are at the doctors and he tells you the reasons why he is doing what he is doing it’s seems right at the time to us . But I will speak to him again and ask for the bone scan to be done before the biopsy . But what if the bone scan comes back clear he will then need a biopsy ? And if it doesn’t come back clear and he has cancer in the bones what happens then .? How will they know the Gleason score if he doesn’t have a biopsy ? So far the ultra sound was clear but psa was high , blood test other than the psa everything was normal good in fact . Urine flow test was fine Ct and mri came back saying 2 lymph nodes on the right hand side of his pelvis were slightly enlarged , no masses in prostate gland weight of prostate 32g but it says it should be between 30 and 35 it said there was slight indent in the eurethra and in his spine T10 and T12 vertebra needed more investigation due to psa level . But most things stated as unremarkable Then he took a 2nd psa test and it came back at 35 down from 122 which you say and he says could be due to the casodex . That’s what we know . He asked about his hernia surgery and wanted to know if mesh was used as it was a massive hernia we said yes it was so he wants to get the notes from that op . Don’t know why .
Your brother should have had the bone scan first too.
If bone scan is negative -> he needs a biopsy
If bone scan is positive -> he does NOT need a biopsy.
"How will they know the Gleason score if he doesn’t have a biopsy ? " You do not need to know a Gleason score if he is metastatic. Once he is deemed metastatic, the Gleason score no longer matters. The Gleason score is only useful if the cancer is only in the prostate gland. Treatments will be exactly the same if he is metastatic with GS7 or if he is metastatic with GS10. Only the number and location of the metastases matter.
Hernia surgery may preclude robotic prostate surgery.
Ok thank you .
The first urologist also put him on omnic ocas because he thought it was a uriny tract problem
When I started my initial treatment for metastatic cancer I had Lupron plus Casodex (25 mg) for one year. My PSA dropped from 4.48 to 0.17 during the first three months. Later on, when I restarted Lupron I didn't take any Casodex. This time my PSA dropped from 0.453 to 0.263 during the first three months. Could the more rapid fall during the first ADT cycle be due to addition of Casodex?
It prevents the surge of testosterone from activating androgen receptors. If one is diagnosed as metastatic, there's much better stuff now.
Mr. tall_AllenI have metastatic prostate cancer with a 520 PSA. I am on Casodex about to take Lupron. You mentioned there is "much better stuff now". Please help inform me.
What's your situation? Newly diagnosed or recurrent? How many metastases? where? What drugs/therapies have you used so far?
Why take for only 2 weeks? If a drug treatment works, stay with it.
Because we were told to stop it as he hasn’t been diagnosed with cancer yet . And TA said he shouldn’t be taking it yet so we stopped it .
Got it, TA is right if not diagnosed don't take it at all.
We stopped taking it already . And are now with a different urologist .
I had a PSA of 156 with no symptoms I first got a DRE. Then a biopsy that confirmed cancer, then a bone scan (negative) then a CT scan ( Lymph Nodes enlarged) then a couple months of figuring out what to do, second opinion, etc. This was clearly not in the right order but its how my Urologist proceeded. I was handed off to Oncologist after my biopsy. The reason TA says bone scan first is because if there's obvious bone involved need for biopsy. Before my treatment started had another PSA test, it had dropped 60 points (not common) to 95 but back up to 110 in 10/2019. Started treatment (no Casodex for me) Lupron 10/2019, Zytiga 11/2019. PSA 4.7 11/2019, .8 12/2019. I had radiation started 1/2020 became undetectable in 5/2020. I am still undetectable and hope to stop my meds in mid September to see how things go.
That’s amazing news I’m so so happy for you and hope you carry on this well for many more years good luck 👍
Well speaking to the urologist he said once they get the results it’s goes before a panel . Urologist oncologist radiation oncologist and work out the best treatment for john. Then they go through it with us and tell us the options .
Its a process in all countries so I was hoping to give you an idea of what you might have ahead based on similar PSAs. Of course if there's bone metastasis then it would more likely be Chemo here in the US. We have a guideline called NCCN that many hospitals and.doctors follow here. Once I was aware of it I realized most Drs will follow that pretty closely and a few will be bold enough to try other options on patients that don't fit nicely into that box. I hope everything works out for John? Is that your husband?
Get the PSMA scan and spare the man from the bone scan radiation. The US is many years behind on this. Taking the Casodex initialy is believed to stimulate the tumor cells to express more PSMA. So, you have an advantage here to be lost if changing course. Extended use of ADT attenuates the initial PSMA surge.
You need to take Casodex, i.e., bicalutamide, for at least 6 weeks to have any real effect.
You should know that there are several drugs proven to dramatically enhance the cancer killing effects of bicalutamide and these drugs are:
EGCG
Metformin
Isosilybin B
The strongest enhancer of the ability of bicalutamide to lower PSA and directly degrade the receptor sites on cancerous prostate cells is Isosilybin B. Both Isosilybin B and EGCG can be purchased without a prescription. DO NOT TAKE less than 50mg of bicalutamide because it has been shown to accelerate prostate cancer in lower dosages.
I also recommend 4-methylumbelliferone (4-MU) which I have taken now every day for the last 12 years at a dosage of 400mg 3x day. It will age your skin slightly but it blocks bone mets.
Don't just rely on what your physician recommends! If I did that I would have died 12 years ago!
To be honest he took 50 mg for 16 days , and his psa dropped 72%. I looked on the internet and all I can see is that it drops when you take 150 mg andluperon or when you stop taking it .he stopped taking it on Tuesday and had a psa test Thursday morning we were shocked it had dropped that much .
Dear famousc, Thanks for this information. I am trying to put together what I need to ad to my battle. There are so many things that men here are doing it has been confusing. I think what you are doing may be a fit for me. If possible please update me on any additions as will I forward changes to you.. BTW you do not appear as a member ?
много 👍
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