How soon do you get side effects from Lupron shot?

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Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/24/2009 10:11 AM (GMT -7)   
Got my first one month Lupron shot on Monday. No side effects yet in any department. How soon do they develop?

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by RRP at Duke (Dr. Moul) on 6/16/2008

Pathology

Gleason downgraded 4+3=7

  Duke: T2c N0MX, one positive margin

  Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then

2/6/2009

0.10

4/26/2009

0.17

5/22/2009

0.20

6/11/2009

0.27

6 Months ADT started 6/12/2009

IMRT to start mid-Aug


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/24/2009 10:32 AM (GMT -7)   
No sooner than I wrote this, I got my fist hot flush. Nothing horrible, I have to say. Just got very warm all of a sudden and then returned to normal a few minutes later. I can live with this if this is the worst of it.

I do want to know what else to expect and when, so please chime in...

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/24/2009 10:45 AM (GMT -7)   
Geebra,
It took me a month and a half for hot flashes and 6 months later it was affecting me in a whole new way. The worst of it for me was adjusting to the angrogen deprivation. Low "T" levels can and will likely cause depression. I had to take a break from moderating here and get my "new mindset" in order to cope with depression. But I am doing very well now and the best advice I can give is don't be caught off guard by changing moods and feelings. Since I have been on ADT I also lost my ability to participate in sexual activity with my wife. Libido is very low, subzero low, and this too can lead to depression.

All in all, if you are able to recognize and address coping with these side effects, you can do very well. I figured it out, but I know many guys who struggle with it.

Peace to you, and stay positive!

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/24/2009 11:17 AM (GMT -7)   
Thanks, Tony. I am already dealing with depression, so I am seeing a therapist and will start antidepressants shortly. I am feeling better, but will watch out for more signs...

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 6/24/2009 1:30 PM (GMT -7)   

Hi Geebra,

The side effects of the lupron started in earnest about two weeks after the first shot. (I just had my fourth a month ago). Hot flashes were fairly frequent and intense but of short duration. One year later and just after my fourth shot the hot flashes do not seem to come as often nor as intensely. Thankfully, the duration is still short.

Other side effects are:

   1. Loss of libido. Since I am single that is not a problem for me.

   2. Loss of body hair. Especially on legs and chest.

   3. Weight gain. I put on about 20 lbs fairly rapidly in spite of a vigorous workout program and running. I have managed to get about 6 of those back off.

   4. Loss of muscle mass. Took about a year for this to show up. Most evident in my upper arms and shoulder. I have had to cut back on the weights to a lower amount. Still three times a week. My running time is off by three minutes per mile. (was 10 now 13) Still in the gym everyday though.

   5. Shrunken testicles. The doctor did not mention this in his briefing but seems that others have had the same experience.

   6. Depression has not been a problem for me. I do seem to be a bit more sensitive to sad stories on the news and in the papers so I avoid them if possible. I think the exercise helps with this item.

Good luck with your IMRT. My own was not all that tough with only a brief episode of bowel and urinary problems midway. No issues after completion.

Let us know how you are doing. Keep your spirits up it does get better as you adjust to the new reality.

Take care,

Don

 


Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
 
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/24/2009 1:59 PM (GMT -7)   
Geebra,
There are two new studies out that show that two year ADT with IMRT is showing better mortality rates than 6 mos. with IMRT. I would ask your RO about it. He should have that information.

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 6/24/2009 2:14 PM (GMT -7)   
I had a 3mo shot to assure that my PC wouldn't progress until I could take care of it after tax season (either that or go out of business). It took me a month to notice any side effects. My hot flashes only happened at night and were fairly frequent. I was also able to joke that I now looked like a little boy. I also became impotent but the lack of libido meant I didn't care. <G> I didn't notice any weight gain or loss of muscle mass but I was swimming laps daily. I actually lost 7 pounds by the time I checked in for surgery. My wife has since noticed a loss of upper body muscle since I haven't been able to get back to the pool. Maybe next week. I didn't know depression was a possible side effect so I guess I didn't have it.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/24/2009 4:34 PM (GMT -7)   
Thank you, guys! I will increase my excercise regiment and decrease food intake. I have been working hard to loose weight and lost 15 pounds over last three months or so. Don't want to gain it all back.

Tony, can you possibly post the references to the sdudies you mentioned? I will definetly discuss this with my docs.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/24/2009 8:56 PM (GMT -7)   
Here is a good post about ADT and radiation....From the Infolink...The study is linked...
 
 
Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/24/2009 9:00 PM (GMT -7)   
Here it is from PubMed...
 
 
Tony

Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/25/2009 8:45 AM (GMT -7)   
Thanks, Tony.

I discussed this with my Oncologist. He knew about this study. He says it is relevant for primary treatment, but is not yet accepted as a salvage treatment. He feels 6 months ADT will be enough, but we will revisit this in a few months.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4168
   Posted 6/25/2009 9:08 AM (GMT -7)   
A lot of patients use Luron to stop the PC to buy more time to make a decision or use it to shrink the prostate and tumor prior to radiation.

Casodex alone works just as well for these purposes and has about 20% of the side affects of Lupron. Be sure to take Femera along with any HT as it will stop any breast enlargement. Taking proscar is also encouraged along with the Casodex. Side affects are loss of libido and minor hot flashes.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 6/25/2009 1:38 PM (GMT -7)   
It took my dad about a month of HT before he experienced any side effects. The hot flashes were pretty bad, but they have either gotten better or he has gotten used to them, because he doesn't complain about them very much anymore. Loss of Libido is another big one, as previous posters have mentioned. He also experience hair loss on his body. He has always worked out quite a bit, but I think his energy has been affected, because he doesn't go to the gym as much, either that or maybe a little depression. Just my observations. All in all, he looks great and we pray that his PSAs remain undetectable. Best of luck and keep us posted.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/25/2009 5:33 PM (GMT -7)   
Latest blood test results (2 wk Casodex, 1wk Lupron) - PSA=0.1, T=516. When it drops below 0.1, can I re-join the zero club or does it have to be without hormons? smilewinkgrin

KeyWestPirate
Regular Member


Date Joined May 2009
Total Posts : 60
   Posted 6/25/2009 6:49 PM (GMT -7)   

Depression and short term memory loss were the worse aspects for me.  I couldn't remember what I had seen on TV the night before.  The hot flashes were miserable, cost me a lot of sleep.  It all interacts:  tired, no energy, lost sleep, a hot flash when you least expect it  (is it hot in here or is it me  -AGAIN?) = a depressed state .    Some days I felt like walking in front of a bus.  There's also this pissiness.  My wife had gone through menopause a couple of years earlier, so I did get a lot of sympathy, plus a lot of  "Now you know what it's like" gloating.

The libido aspect is kind of strange:  It's true that you have no desire, but I got my Lupron pre-RP, so I had no erectile issues.  Once I got started (with sex initiated by an exasperated wife) I had no performance problem and a normal erection and orgasm.  It's not that you CAN'T do it, it's just you couldn't care less.  I ddin't get any CASODEX moderation, so I had the testosterone flare, lasted about a week.  Whoo!  Whoo!.     I went from wanting sex all the time, to absolutely no interest whatsoever, all in about a month.   Interesting period in my life.  Don't want to do it again.

I understand from reading that the side effects moderate after a while, but I only got the one 4 month depot shot  June2008).  I didn't recover from it until I got testosterone replacement therapy (Andorderm patch) in Jan 2009.  Robotic RP was Nov 23 so I was pushing the envelope a bit.  One of the first things I noticed was that I was looking at the women in the supermarket again.   Here's an interesting and encouraging link:

http://www.ustoowichita.org/pdf/MYPROSTATECANCERSTATS.pdf

I suspect that T replacement could be a very valuable addition to post-op erectile rehabilitation.  I also suspect that you are not going to find a single urologist in the world who would adopt such a protocol  -and with good reason. 


DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 6/26/2009 6:31 PM (GMT -7)   

I have to ask-are there any men out there who still have desire after getting hormone therapy and enjoy a passionate kiss?

Dana


SO diagnosed 4/15/09 age 47
1/15/09=PSA 10
Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present
Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present
T2c
5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong
pre-op PSA 15, MRI shows extracapsular penetration
Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared

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