16 weeks of HT - How bad is it?

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BoisePSABantam
Regular Member


Date Joined Apr 2009
Total Posts : 20
   Posted 4/12/2010 3:33 PM (GMT -6)   
I might be going thru 16 weeks of HT before and during radiation therapy(1 shot of Lupron + daily Casodex). How bad are the side effects? Did they stop you from exercise or fishing?

Thanks!
Pre-Surgery PSA: 4.92
age: 45 at DX.
DaVinci 5/07
1st PSA 0.07 8/07
2nd PSA 0.04 11/07
3rd PSA 0.04 02/08
4TH PSA 0.04 7/08
5th PSA 0.08 2/09
6th PSA 0.08 5/09
7th PSA 0.07 9/09
8th PSA 0.13 3/10


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 4/12/2010 4:05 PM (GMT -6)   
Hi and welcome from me. I have done 5 months of Lupron, with 3 to go on my current course of treatment. Did 32 RT sessions at the same time. Good news is that I was able to go to the gym every day, and definitely could keep on fishing.Also don't need to shave as often. Bad news is that I have gained about 20 lbs anyway, and find myself wanting to watch soaps, and go for the BOGO at shoe stores. Hot flashes all the time, bearable during the day, but they wake me up at night, so sleep is not the best. But...I can do this, and so can you.
All the best.
Roger

 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.

12/18/09          psa 4-Month <0.01 undetectable. MRI/CT scan set for 1/5/10 for IMRT planning. RT to begin week of 1/11/09. Anticipate 64-66 grays over 32-33 treatments.

1/14/10            Start RT with 32 treatments # 2 gys per.

2/26/10            IMRT completed.

 

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. After 1/16/10 down to a female regular pad. Barely felt.

 

 

 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 4/12/2010 4:29 PM (GMT -6)   
Why only 16 weeks? I understand the protocol to be 13 or 24 months?

JT

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.

JohnT


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 4/12/2010 4:53 PM (GMT -6)   
Hello Bantam,
 
I am coming up on 2 years of Lupron. Side effects are tolerable and the hot flashes have diminished over time. I kept up my gym routine through my 45 radiation treatments and through the lupron. Still put on 15 lbs and they just do not want to come off. I confess that the last week of my rad treatment I only went to the gym once but I still walked for 45 minutes everyday.
 
Like John, I am curious about the term of your HT therapy. I did see some research that indicated a short term of six months was beneficial under some circumstances. My oncologist is talking about adding another year to mine.
 
Best to you.
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

PSA 06/09 .36 or .30 depending on who did the test

PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/12/2010 4:55 PM (GMT -6)   
Bantam,

Good luck on what lies ahead for you, will be an endurance contest for sure.

David in SC
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


IDguy55
Regular Member


Date Joined Mar 2010
Total Posts : 27
   Posted 4/12/2010 9:16 PM (GMT -6)   
I did 45 days of Radiation at St. Lukes MSTI in Twin Falls. It was somewhat tiring, but part of that was the 2+ hour drive every day. Towards the end I was getting some skin burning, like a mild suntan where you usually don't get a suntan. I didn't have HT at the same time. I started HT (3 month Zoladex only) last August. Since I had a good PSA drop I skipped 3 months and then had another round of Zoladex in February. My main side effects have been mild to moderate hot flashes that started about 5 weeks after the injection. After the first shot they tapered off after about 14 weeks. As others have said, you really have to watch what you eat and try to keep up the physical activity.

Best of Luck, Dallan
Current Age 55, DX October 2005 PSA 50
Biopsy 11/15/2005 Gleason 4 + 3, High Grade PIN, Perineural Invasion, T2 NX MX Stage 2
Bone Scan Clear, CT Scan Negative
open RRP on 12/19/2005 Gleason changed to 3 + 4, Tumor estimated at 25% of prostate volume, Negative Margins,
Extensive Perineural Invasion, Lymph Nodes Clear, Catheter removed 1/3/2006 (holidays) Dry at night. moderate incontinence during the day.
1/25/2006 PSA .046, Moderate Incontinence
2/28/2006 PSA .027
6/22/2006 PSA .043 Just a little stress incontinence
9/08/2006 PSA .065
IMRT Start 10/12/2006 45 treatments 80 gy
1/4/2007 Almost Total Urinary Blockage, Cystoscopy performed, The next few days I had the Urinary tract of a teenager.
1/8/2007 Clogged up again, Catheter put back in. Removed myself (highly recommended) 7 days later No problems since with only occasional very mild stess incontinence since.
1/11/2007 PSA .03
7/26/2007 PSA .011
1/24/2008 PSA .027
5/22/2008 PSA .104
9/25/2008 PSA .383
2/17/2009 PSA 1.06
5/12/2009 PSA 1.5
8/25/2009 PSA 3.8 LHRH agonist (3 month Zoladex) started
11/24/2009 PSA .021
2/23/2010 PSA 0.99 another 3 month Zoladex


IDguy55
Regular Member


Date Joined Mar 2010
Total Posts : 27
   Posted 4/12/2010 9:19 PM (GMT -6)   
Oh, and I when I was at the Williams-Sonoma store with my wife I just loved the white dishes with the blue edges!!
Current Age 55, DX October 2005 PSA 50
Biopsy 11/15/2005 Gleason 4 + 3, High Grade PIN, Perineural Invasion, T2 NX MX Stage 2
Bone Scan Clear, CT Scan Negative
open RRP on 12/19/2005 Gleason changed to 3 + 4, Tumor estimated at 25% of prostate volume, Negative Margins,
Extensive Perineural Invasion, Lymph Nodes Clear, Catheter removed 1/3/2006 (holidays) Dry at night. moderate incontinence during the day.
1/25/2006 PSA .046, Moderate Incontinence
2/28/2006 PSA .027
6/22/2006 PSA .043 Just a little stress incontinence
9/08/2006 PSA .065
IMRT Start 10/12/2006 45 treatments 80 gy
1/4/2007 Almost Total Urinary Blockage, Cystoscopy performed, The next few days I had the Urinary tract of a teenager.
1/8/2007 Clogged up again, Catheter put back in. Removed myself (highly recommended) 7 days later No problems since with only occasional very mild stess incontinence since.
1/11/2007 PSA .03
7/26/2007 PSA .011
1/24/2008 PSA .027
5/22/2008 PSA .104
9/25/2008 PSA .383
2/17/2009 PSA 1.06
5/12/2009 PSA 1.5
8/25/2009 PSA 3.8 LHRH agonist (3 month Zoladex) started
11/24/2009 PSA .021
2/23/2010 PSA 0.99 another 3 month Zoladex


Navyman
Regular Member


Date Joined Nov 2009
Total Posts : 22
   Posted 4/12/2010 10:07 PM (GMT -6)   
Your one course of Lupron/Casodex probably wont lead to the severe side-effect that I experienced with osteoporosis after 24 months of HT. Fortunately I didn't experience the dreaded hot flashes.
However, no one has mentioned the enlarged breasts and tender nipples that can develop. Mine started developing at about 3 months; 6 months after the last shot they show no signs of returning to normal. With only 4 months of HT you may not notice such changes.
Best wishes for a successful course of treatment.
72 years old, healthy and active, single.
Diagnosed 9/05/07 PSA 18.09
Biopsy 12 cores all positive, Gleason 4+4=8 Stage T2
11/07 Began 24 month HT Lupron Depot and Casodex
1/08 3d Conformal 36 sessions followed by IMRT 7 sessions
(hospitals first IMRT patient)
PSA: all followup tests continue to be undetectable
8/09 Final Lupron shot
8/09 Severe osteoporosis from HT leading to need for spinal fusion
10/09 Levitra, Cialis at highest doses gave 60% erection
11/09 Edex at highest dose gave 75% erection with aching
12/09 Cialis daily 5mg + Trimix gives 75% erection with no aching
1/10 Adding VED hoping to increase blood flow
4/10 VED gives 95% of pre-treatment size; return of nocturnal erections


BoisePSABantam
Regular Member


Date Joined Apr 2009
Total Posts : 20
   Posted 4/13/2010 7:41 AM (GMT -6)   
Thanks for the heads up! This is a good site for advice.

The reason for the short HT is that this is a clinical study where they are evaluating whether adding HT to Rad will make a long term difference. I find out today what the exact protocol is going to be.

I exercise 9 - 12 hrs a week and eat a disciplined vegan + fish diet. If I couldn't exercise or fish I'd go nuts and starve to death.

I'm hoping the HT will wear off by September and I can get back to normal.
Pre-Surgery PSA: 4.92
age: 45 at DX.
DaVinci 5/07
1st PSA 0.07 8/07
2nd PSA 0.04 11/07
3rd PSA 0.04 02/08
4TH PSA 0.04 7/08
5th PSA 0.08 2/09
6th PSA 0.08 5/09
7th PSA 0.07 9/09
8th PSA 0.13 3/10

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