How can I minimize side-effects from LUPRON ?

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Regular Member

Date Joined Nov 2009
Total Posts : 206
   Posted 11/16/2009 1:45 PM (GMT -6)   

Started Casodex ( 50mg. for 30 days) last week and

the brochure that came with it mentions possible side-

effects of nausea, diarrhea, itching and feeling weak.


The only change I have noticed so far and is not

mentioned is extreme dryness inside the mouth’

during the night.


It does wake me up so I get a small glass of water

and that helps to get me back to sleep.


Next week I get a Lupron ( 22.5 mg, 90 day) shot but

the side effects listed for that seem so much worse:

hot flashes, increased sweating, night sweats, tiredness,

swelling of the feet, mood changes, depression, ETC !


None of these I’m looking forward to so I’m wondering

If there are precautions I can take to minimize

these possible conditions ?

Age, only 71.
July 2009, PSA 8.7
September GLEASON 8, T2A
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. (not ordered
by first urologist)
Started Casodex 50mg. on November 6, first pill of 30. Start Lupron on about November 20.
Open surgery expected before end of February.
Need to get this over with so next year I can 
continue with motorcycling and sailing TOGETHER
with my wife, Debbie.

Regular Member

Date Joined Apr 2008
Total Posts : 364
   Posted 11/16/2009 5:37 PM (GMT -6)   


Everyone reacts a little differently to Lupron, I've been on it for a couple of months and the only side effect I've noticed is hotflashes.  I think this is the one side effect that we all seem to have.  The longer you are on the stuff, the more side effects you seem to have.  There will be some guys that have been on it much longer than me, that will be able to give you more info.  but for me so good so far I guess.


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 11/16/2009 7:49 PM (GMT -6)   
The PCRI web site has a lot of information on HT side affects.
Ask your doctor about Femera or a like substitute as it will stop any breast growth. Also there is a new drug, I think it's called Estis or something like that that will eliminate hot flashes. My neighbor who has been on HT for 12 years just started taking it and said it was wonderful.
You must start an excercise program that includes weights. This will prevent muscle and bone loss and help if you have a tendency for depression.
Ask your doctor about supplements; Vit D3, Calcium, COQ10 if you are on satins,
Make sure your doctor gets you a bone desnity test to establish a baseline and an Echo Stress test because HT does affect the cardiac system. If he has not already done this then I would look for another doctor that is more experienced in administering HT and its side affects.
Different people react differently to HT and side affect go from minimal to severe so it is important to get treated by an experienced oncologist who can manage the dose and side affects.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Opa N
Regular Member

Date Joined Sep 2009
Total Posts : 150
   Posted 11/16/2009 7:50 PM (GMT -6)   
I had my first Lupron injection on 10/21/09, 3 weeks ago more or less. Dosage was 30 mg, 4 month shot.
To date, I have had a few night sweats, which may be a result of Extra Strength Tylenol I take at night for arthritis pains, and not the Lupron. I am waiting for other symptons to appear, but nothing to date (not even a desire for shoe shopping).
Whatever comes is going to come anyway, so go with the flow is my plan. Lupon is going to help me a lot.
All the best.

 Age 67 at diagnosis. Treated for coronary artery disease (CAD) since 1998, and under control with medications.

2/6/09              Routine physical, with DRE and PSA Test. PSA 4.02. Referred to Uro

4/20/09            TRUS  w/needle biopsy

4/23/09            Diagnosis PCa with Gleason 4+3 in 2/2 cores, Gleason 3+3 in 5/10 cores.

                        CT scan and Bone Scan both negative. Stage T2C.

8/27/09            DaVinci RP at WakeMed Cary NC with Dr. Tortora. Discharged 8/28.

9/8/09              Catheder removed. Path post-surgery confirms PCa, with Gleason 3+3 with scattering of 4. Positive margins in L & R posterior, R and L seminal vesicles, with perineural invasion.  Stage pT3b.

9/30/09            PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Prostate Oncologist and Radiation Oncologist. Appointments set for 10/8.

10/8/09            Met w/ both oncologists. Adjuvant Combination Therapy to begin ASAP.

10/21/09          First Lupron injection. 30 mg dose (4 month)

11/2/09            PSA 2-month <0.01. Cystoscope w/calibration and dilation to remove scar tissue from urethra. Big relief.


Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradually getting better, with dramatic reduction in leakage around 9/20. Currently on 1 pad during the day and one at night (for security). Actually totally dry at night.




Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 11/16/2009 8:41 PM (GMT -6)   
Ditto on John T's information line on this, myself did 2 yrs. of ADT3 (the max deprivation blockage plan), it was not much fun. The only fun is watching the psa numbers decline, little Willy will decline too (lol). You can get through this and it ususally does render results, you having surgery in Feb hopefully will be done with this stuff, but for others hopefully do not have to do this protocl super long term, maybe intermittent or quit at some juncture. There are other drugs and therapies that are useful and can be used, most uro-docs either don't know about them or don't want to know about them or heaven forbid find these others unprofittable, if you fail psa on these drugs you need to see an onco-doc as that is their realm.
Fyi-surgery after taking these types of drug therapies, shrinks the gland and also makes it more difficult for surgery, some surgeons do not wish to or like to work on patients whom have done this prior to surgery....have you heard that. Might make the gland more of a sticky mess to cut is the concept, I believe.

Post Edited (zufus) : 11/16/2009 6:47:40 PM (GMT-7)

Regular Member

Date Joined Jun 2009
Total Posts : 292
   Posted 11/17/2009 4:47 PM (GMT -6)   
I was on Lupron so I could safely delay surgery until I got through tax season. I didn't notice any real affects for the first month. I sort of wondered what was going or not going on. After a month I got nightly hot flashes and 0 libido. I exercised almost daily but my wife still noticed a decline in muscle tone. It was a three month shot and but the effects didn't seem to end until for four months after I got it. Now that my wife is getting hot flashes she appreciates that I can understand what she is going through.
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 PSA 9/10/09 <0.1

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 11/17/2009 6:51 PM (GMT -6)   
Lots of great advice has been shared on this topic, I would however like to add the need for exercise to offset some of the fatigue. I was on Lupron Casodex for two years and there were times I was so tired I could not get off the couch, but I would force myself to get moving and it always made me feel better. Stay as active as you can physically and mentally.

peace to you
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
PSA OCt 15th 2009 is .11

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

Hopeful in MD
Regular Member

Date Joined Apr 2009
Total Posts : 66
   Posted 11/17/2009 9:19 PM (GMT -6)   
Hi JB,
I've had only two Lupron shots (4 mos ea. 30 Mg).  At first, I felt that I was depressed.  I am the first to admit that I am not very much in touch with my feelings, but was probably correct about depression.  Sometime after the 1st shot, I also felt a lot of fatigue.  It went away after a month or two and so did the depression.  I have tried to counter the side effects with treadmill and 5lb bar bells.
You will almost certainly get hot flashes.  I mentioned them to my uro and he asked if I wanted something for them.  I'm already on a bunch of meds and declined.  The flashes sometimes make me sweat some, but a tower fan quickly compensates.  They are not a big deal, and since the Lupron has brought my PSA down to 0.5 from 3.9, I have no complaints.
I echo the advice of a number of others here; be sure to exercise.  You will actually feel much better.  Second, check out Vitamin D and Calcium - ask your doc.  I am on a supplement of 2000 IU of Vit D, Calcium, Magnesium, Strontium, and Boron.  My uro says it's the best supplement he knows of.
I may be one of the lucky ones, but I'm early in the HT treatment.  Can't really find much to complain about.
Good luck.
Gene in Md
Age 70.
Dx Dec 07. PSA 8.4. DRE confirmed tumor. Three of six positive. Gleason: 6 (3+3). Seeds Iodine 125 Jan 08. PSA's 3.9, 1.7. Rising PSA's: 2.3, 3.4, 3.9, indicating  seeds not working.  April 09 began HT with Lupron 30 MG ea. 4 mos.  Side effects hot flashes, severe fatigue until mid-July. Jun 09 - Onco DRE negative for nodules - hooray!!! Aug 09 - PSA 0.5!!!  Lupron working! Aug. 21 - 2nd Lupron shot.  Aug. 31 - hyperbaric oxygen for rectal bleeding (radiation proctitis).  40 sessions as of Nov. 9.   Nov. 5 sigmoid exam - gastro "oxygen not working." Hyperbaric doc "they are" confirmed by Nov pics compared to Sep. Will continue treatments up to 60, the max nr for one course of treatments. 

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