New Thread Created for Danny-47: Hormone Therepy questions

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James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 1/4/2009 9:00 AM (GMT -6)   
Danny-47 asks in another thread about his protocol in another thread. His questions are important and may be buried in that thread, so I am moving them here in a seperate thread for him.: He Asks:

I go for bloodwork every three months and hold my breath for the month before each test. I was diagnosed in Feb 2005 and have been on Casodex and Trelstar/Lupron ever since. My PSA dropped from 39.5 to undetectable and has stayed at or close to that level. My wife and I do not make long-term plans but plan our activities (primairily trips) after each good visit to the doctor.

I have a few issues that, hopefully, I can get some good imput to point me in the correct direction.

1. I continue to be on Casodex because my Oncologist indicates the combined blocade is working. Is this a normal protocol?
2. I have been experiencing pain on one nipple. The pain keeps getting worse. My doctor said this is normal and once possible solution is radiation. Any others with this experience?
3. Am I the only one who gets depressed at night, often making sleep difficult.

Any input would be appreciated.


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Date Joined Dec 2008
Total Posts : 3149
   Posted 1/4/2009 1:55 PM (GMT -6)   
Yes that would be Combined blockade or ADT2 has other names too. It can be more effective as the lupron drug blocks testostorone-"T" from the testicles (80-90% is probably produced from there), it does not touch the approx. 10%+- that is produce actually by the adrenal glands. However, casodex takes care of that via anti-androgen effects it does. So, it is close to total suppression (deprivation) of "T" which is the fuel for PCa that needs to be shut down in effect.

Casodex can produce nipple tenderness and even possible breast enlargement over time, there are drugs you can buy to counteract that and/or you can have breast radiations done to stop enlargement and the tenderness issues (I know cause I did those, it was not a big deal and not a scary thing), you might elect for the drugs to take against that.

Depression is common on any hormone suppression program, not only can you read about, hear it from other patients, I been there and felt that big time. Hated it after a couple years but have moved on, lots of ways to deal with PCa and emotions, side effects etc.
Hang in there and research all your choices for therapies, you have an oncologist which is great, do note that they can have different protocols, in other words they all don't agree on just one set of protocols, or they may switch protocols on you depending upon how you are doing on them.

N-Bob 7yr survivor with uncureable PCa bpsa 46.7 12 pos. bio. 75-95% cancerous, gleasons 7,8,9's (psa currently 1.4, off drugs for 2 yrs prior and psa rose resuming my drug off choice therapy)

Post Edited (zufus) : 1/4/2009 1:58:10 PM (GMT-7)

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Date Joined Apr 2008
Total Posts : 1382
   Posted 1/4/2009 2:13 PM (GMT -6)   
Great answer not much to ad. I would like to welcome Richard to the forum and hope he joins in and takes part in the discussions.

peace and love
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .06
Testosterone keeps rising, the current number is 156, up from 57 in May
cancer in 4 of 6 cores

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Date Joined Oct 2008
Total Posts : 3218
   Posted 1/5/2009 6:45 PM (GMT -6)   
Hey Danny
I have been on hormones foe 32 months. I have very little to add to the first reply about treatment.
What I do have to add is this. Dont wait on a good Dr. appt to make plans with your wife. Live your life with all your heart. Cancer is a scary word. It is so scary that it often causes people to stop living and start dying. Wake up early and listen to the birds. Love with all your heart. Treasure each day. It is not the quantity of life it is the quality. Today I cannot be cured. Maybe tommorrow I can be. Maybe not. I wont waste today worrying about what may or may not happen. I know this sounds hard but I lerned early on that all people are terminal. Nobody knows when they will breathe thier last breath. A week after my dx, I jumped off a 40 foot span into the local swimming hole. I used to be afraid to do so when I was younger. There I was standing on that bridge with all those kids looking at me wierd. I went for it and when I hit the water I felt all my fears wash away. I also felt a huge wedgy.
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months
Cat Scan 12/12/08 Prostate normal size and shape. No tumors detected. Left lung clear of all nodules right lung showing only benign scar tissue. Lymph nodes normal
Bone Scan 12/24/08. Clean!!!

New Member

Date Joined Jul 2006
Total Posts : 6
   Posted 1/5/2009 8:29 PM (GMT -6)   
Thanks to all of you for the words of encouragement.

Not long after I was diagnosed, I read a doctor's note which indicated "a median time to progression" for me of 48 months. That was 4 years ago - next month. That thought triggered some revived concerns. However, I believe I am getting past that and am ready to deal with whatever happens next.

"Zufus" mentioned there were drugs that could deal with the nipple tenderness (which makes it difficult to sleep). Any suggestions? I am looking at radiation as a last resort. The pain level is increasing but is tolerable most of the time.

I continue to read far to much on the Internet. Some of this I am sure is outdated.

Age at dx: 56, now 60. PSA at dx: 39.5; gleason 4+5=9 by one radiologist and 3+4=7 by another. PSA has remained < 0.05. Support of wife and children has made a tremendous difference in my mental state, subject to a few setbacks.

Post Edited (Danny-47) : 1/5/2009 6:33:21 PM (GMT-7)

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