what is the difference between lupron and casodex

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kak
Regular Member


Date Joined May 2009
Total Posts : 85
   Posted 12/6/2009 3:52 PM (GMT -6)   
Hi Everyone: In layman terms can you explain what the difference is between these two drugs and how they work? I would appreciate any help. Thanks in advance.
AGe 54 diagnosed March of 2007
PSA 107

Gleason 8

Stage T2 or T3 (weren't sure was out of prostate capsule)

Bone scan march 2007 and Aug 2008 both clear

ct 2007 clear

started casadex/lupron March of 2007 (casadex only for 4 months)(lupron for 2 yrs)

Aug 2007 had 37 treatments (also radiated lymph nodes)

psa spr 07-107,went down to .34 by Dec 08, March 09 0.7, May 1.54,
Added casodex, PSA Aug 1.19, Psa Dec 09 5.65
Going for Bone scan and Ct Scan, than decide what to do with rising psa


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/6/2009 4:26 PM (GMT -6)   
Please get Dr. Strums books on Oncology about PCa and all treatments and testings known at the time of publishing it (includes some on combidex type scan):

www.pcri.org site or amazon.com  (for book- A Primer on Prostate Cancer)
www.hypertext.org  (info site in Spanish, English, Frence?) has links to alot more stuff too

You will find more in this book than you could ever believe. If you have a rising psa like this while doing ADT2 you need an oncologist who knows his stuff, uro-doc is not qualified for this area, which is what PCa oncologists will advise you about, yeah they could be biased but this is their territory.

You are doing ADT2 or have been so, if you add proscar or avodart, then you have ADT3 total blockage of all possible testosterone, including dihydratestosterone which is many times more potent that the normal T production (fyi).

You think this wild, wait till you look at leukine and other stuff we normally don't hear about.

Post Edited (zufus) : 12/6/2009 7:25:06 PM (GMT-7)


kak
Regular Member


Date Joined May 2009
Total Posts : 85
   Posted 12/6/2009 6:10 PM (GMT -6)   
Thanks Zufus you have been very helpful. We were going to ask about avodart when we see the oncologist.
AGe 54 diagnosed March of 2007
PSA 107

Gleason 8

Stage T2 or T3 (weren't sure was out of prostate capsule)

Bone scan march 2007 and Aug 2008 both clear

ct 2007 clear

started casadex/lupron March of 2007 (casadex only for 4 months)(lupron for 2 yrs)

Aug 2007 had 37 treatments (also radiated lymph nodes)

psa spr 07-107,went down to .34 by Dec 08, March 09 0.7, May 1.54,
Added casodex, PSA Aug 1.19, Psa Dec 09 5.65
Going for Bone scan and Ct Scan, than decide what to do with rising psa


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 12/6/2009 6:51 PM (GMT -6)   
Lupron (and other LHRH agonsits, such as Zoladex) inhibit the testicular production of androgen (testosterone).  But there is another source of testosterone production, which is from the adrenal glands (I suppose technically, the adrenal glands don't produce testosterone, but instead androstenedione and dehydroepiandrostenedione -- but they are converted in the prostate to testosterone). Lupron does not inhibit the production of this adrenal testosterone.  That is the role of Casodex -- an "anti-androgen."
 
I agree with zufus that in your situation you want to see an oncologist who specializes in prostate cancer.  ADT3 is a possibility but because of the lack of solid scientific evidence that it works, many oncologists don't do it.  A real expert is more likely to be willing to try it. 
 
I also suggest asking your doctor to test your testosterone level and DHT levels.
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/6/2009 8:01 PM (GMT -6)   
Some of you guys may not realize how the system works in Canada. Kak is tickled to see a doctor period in less than 2 or 3 months. We Americans get a little carried away with decided what type of doctor we want to see and what their qualifications should be.

I think Kak is doing exactly the correct thing, and knowing as much as she can so she can direct the doctor she is given how they would like to proceed.

Good luck Kak !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/7/2009 6:14 AM (GMT -6)   
Medved- good answer on the LHRH vs. casodex in short style

Goodlife- thanks for the input about kak being on the Canadian side and agree anyone needs to know all they can, Kak could decided to come to USA and find a PCa onco-doc, or is it possible to see Dr. Labrie in Canada (assumed he is still alive) he is a pioneer in oncology on PCa. Try researching him or his medical contacts. There are good reasons for specialists in anything, a doc is a doc is Not. Ones outcome could be the same in dying or living, but the quality of the trip and longevity could vary greatly.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/7/2009 8:44 AM (GMT -6)   
Medved - give you credit - you answered the question directly, it wasn't my question but I learned something new from it myself
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


midi
Regular Member


Date Joined Apr 2010
Total Posts : 122
   Posted 6/6/2010 1:54 PM (GMT -6)   
If your on Casodex and it's working do you still need to take the Lupron (Eligard) injections?
White Male 55
 
January PSA: 17.4
March PSA: 36.8
 
Cipro: three weeks
Macrobid: one week
Levaquin: 10 days
 
Cystoscopy: April 19th 2010
 
Self-cath still 4-6 times a day
 
PCa Biopsy performed May 17th 2010
 
Size: 54 grams
 
Gleason Score 4+5


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/6/2010 3:59 PM (GMT -6)   
With PCa there are no set rules in stone, many people have used casodex as 'mono' therapy with great results (atleast for some decent period of time). Brother A. (on this forum) is currently on mono therapy and has done so well, currently about 1 yr., he is testing the waters and going off the drug and monitoring and may resume drug or switch, if and when psa warrants doing something(right now he says doing fabulously well).

Dr. Labrie (Canada-onco doc) was a pioneer in mono therapy with casodex or flutamide drugs. Logically to us it seems more power against PCa is better, especially for higher stats (risky) patients, so ADT2 (combo) or ADT 3 combo seems logically better and may be better...doesn't mean it is necessary to treat all patients with that particular protocol. Then there is high dose casodex going from 50 mg, to 100 or 150 mg levels per day, some have done this with great results. Then there is a drug called "Super Casodex"-MDV3100 the most powerful form of it and some have used it. One has to watchout for being "refractive" on casodex when your PCa becomes androgen independant...then believe it or not, it can actually feed PCa and increase your psa numbers and do you harm...this is why you monitor closely. Knowing more about your biology of PCa is critical as to your prognosis and best longevity, etc. There are many ways to treat PCa and many more drugs than most people realize or know about. Realize there is agenda and profits to be made and sometimes that priority is made first over your best interests and lesser side effects. Believe what you want but I have witnessed plenty first and second hand to confirm my thoughts on such. I have a list of probably 50 drugs known and used on PCa by various onco docs, it is a wild world in PCa. Different paths can have similar results and vice versa, it is literally a jungle and full of inconsistencies and unknowns.


Youth is wasted on the Young-(W.C. Fields)

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