Lupron, Hot Flashes, and Megestrol

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Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 5/20/2010 7:57 AM (GMT -6)   
I posted back about 10 days ago that my Uro prescribed Megestrol after I complained about hot flashes and night sweats as a side effect of being on Lupron for HT.

He started me off on a dosage of 10 mg, twice a day, for a week. Then, unless the hot flashes were managed, I should increase the dosage to 20 mg, twice a day.

The first week, the hot flashes were not as intense, but still there. So I went to the higher dosage. I can report that for the last 3 nights I have not been wakened with night sweats, nor have I felt any hot flashes. It’s great to get a good night’s sleep. Hope this is helpful for all you guys on HT.

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 T3b.
9/30/09 PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Medical 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 1/11/10. Anticipate 64-66 grays over 32-33 treatments.
1/14/10 Start RT with 32 treatments # 2 gys per.
2/26/10 IMRT completed.
3/1/10 Second Lupron injection, 30 mg dose (4 month)
5/10/10 PSA 8 month and 2 month post RT <0.01 undetectable

Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradual improvement, with dramatic reduction in leakage around 9/20/09, to 1 pad during the day and 1 at night (for security). Actually totally dry at night. After 1/16/10 down to a female regular pad. Barely felt. 4/30/10 threw pads away. Dry at last.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 5/20/2010 8:18 AM (GMT -6)   
Nuttin beats a good nights sleep.
 
Will you have to take the meds forever?
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 5/20/2010 10:43 AM (GMT -6)   
Too many patients on HT assume that they just have to suffer through the hot flashes, because they are not told that there are medications than can help. It is good that you mention this, so patients who are bothered by the hot flashes can ask their docs for medication.
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 5/20/2010 10:49 AM (GMT -6)   
Steve,
The Uro wrote the prescription for 60 days. My Lupropn should be wearing off at the same time, so I don't expect to need it after July 1.
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 T3b.
9/30/09 PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Medical 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 1/11/10. Anticipate 64-66 grays over 32-33 treatments.
1/14/10 Start RT with 32 treatments # 2 gys per.
2/26/10 IMRT completed.
3/1/10 Second Lupron injection, 30 mg dose (4 month)
5/10/10 PSA 8 month and 2 month post RT <0.01 undetectable

Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradual improvement, with dramatic reduction in leakage around 9/20/09, to 1 pad during the day and 1 at night (for security). Actually totally dry at night. After 1/16/10 down to a female regular pad. Barely felt. 4/30/10 threw pads away. Dry at last.


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 5/28/2010 9:47 AM (GMT -6)   
An update - Another week with Megestrol, and my hot flashes and night sweats are well controlled at this time with 10mg, twice a day.
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 T3b.
9/30/09 PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Medical 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 1/11/10. Anticipate 64-66 grays over 32-33 treatments.
1/14/10 Start RT with 32 treatments # 2 gys per.
2/26/10 IMRT completed.
3/1/10 Second Lupron injection, 30 mg dose (4 month)
5/10/10 PSA 8 month and 2 month post RT <0.01 undetectable

Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradual improvement, with dramatic reduction in leakage around 9/20/09, to 1 pad during the day and 1 at night (for security). Actually totally dry at night. After 1/16/10 down to a female regular pad. Barely felt. 4/30/10 threw pads away. Dry at last.


keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 347
   Posted 5/30/2010 3:47 PM (GMT -6)   
I'm glad this seems to be helping. Lets get together soon.
 
 
Neal
age 45
psa 3.09
Biopsy results 12/9
Left side base 3+3=6 21% 2/2 cores positive
Left side mid  3+3=6 100% 2/2 cores positive
Left side apex 3+4=7 88% 2/2 cores positive
Right side - 0/6
CT & Bone scan negative
Davinci Feb. 5th 2010/ cath removal 2/16
 
Gleason-3+4=7
Extent of tumor-Bilateral
Extraprostatic Extension-Absent
Seminal Vesicles-Negative for tumor
Surgical Margins-Rt apical margin focally positive
lymphovascular invasion-Suspicious in areas of capsular involvement
Regional lymph nodes-One node negative
Stage-T2c NO Mx
Incontinence-yes/ Down to 1 pad at 6 weeks out
11 weeks pad free
PSA 3/29/10 <0.01


deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 6/6/2010 6:51 AM (GMT -6)   
The doc didn't mention anything to me about meds to couner act the hot flashes but finally after my last pill in Dec-12-10 they hve finally quit June-1-10 boy they got rough at times and i can finally sleep 4 hrs straight for a change then go to the wee glad there is something to counter act the sideeffects of HT guys started should ask for the meds
Keep on getting on
DEERHUNTER BUCKY COMMERCE GA
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  

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