Problems with Casodex?

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Regular Member

Date Joined Feb 2007
Total Posts : 30
   Posted 8/17/2009 11:54 AM (GMT -6)   
I am on IADT3 therapy for the last 6 months.  I have been having shortness of breath for the last couple of months.  I have had a pulmonary work up and a stress test done in the last several weeks which have come back negative.  Has anyone had similar breathing problems attributed to Casodex or was switched to a different anti-androgen (Flutamide) and did this help?
Prostate Cancer diagnosed Dec. 18, 2006
Biopsy 12/13/2006 Gleason score = 3+5=8
RRP Jan. 5, 2007
Pathology - negative margins from succesful surgery
10 mg Cilias M_W_F for 8 weeks
Almost no leakage after 5 weeks
Used Vacurect pump for 4 weeks before useable erection.
Presently using injections - PGE and Trimix caused really bad pain.
Now using Bimix - Bingo, good times are back.
Using very little Bimix and 50 mg Viagra-best combo
1-yr PSA .02
PSA July 2008 - 0.08.
PSA Aug. 2008 - 0.10
Started salvage Proton radiation treatments Sept 2008 at UFPTI.
35 treatments ended Oct. 21st.  Ending PSA .20
Minor uniary and rectal problems cleared up after a month.
Minor rectal bleeding started after 7 months.
PSA started rising after 3 months post radiation.
Started IADT2 Feb. 2009.
PSA Jun/09 0.00, T=29  Hot flashes, no energy, fatigue and  libido gone.

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 8/17/2009 5:22 PM (GMT -6)   
Jerry I was on Casodex for 24 months and do not recall this problem. I have heard of it. If you feel like there is a problem and it sounds like you do I would urge you to talk to your oncologist and force them to listen. I will say this ADT3 is very harsh on the body and without exercise it can take you down. I made sure no matter how bad I felt or how much fatigue I had to keep swimming and walking. It always without fail made me feel better. I made my wife make me get out and do things, otherwise I would lay around and do nothing and then the treatment really gets you. Keep in mind ADT3 causes muscle atrophy which I suppose could cause a shortness of breathe. Keep talking to your doctor and by all means either start exercising or keep exercising.
Thanks for writing and which I could help more.

peace and love
My PSA at diagnosis was 16.3
age 47 (current)

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) 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 .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 8/17/2009 8:08 PM (GMT -6)   
I've been on Casodex for 6 months and the only problem I have is loss of Libido. Hot flashes were minor for the first few months but have seemed to have gone away. No fatigue whatsoever, even with radiation.
It may be the Lupron and not the Casodex.

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


Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 8/18/2009 2:57 AM (GMT -6)   
This is precisely why a flutimide switch is a good thing. Generally Casodex is a better GnRH inhibitor. But it isn't for everybody. If you want to switch, make sure your doctors agree with this decision...


 Age 47 (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  

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