Started HT Today...

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Fairwind
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Date Joined Jul 2010
Total Posts : 3781
   Posted 11/24/2010 3:15 PM (GMT -6)   
I went in this morning to start my 2-year run on ADT...They took blood for another post-op PSA and "T" level also..I thought I was going to get Firmagon, but since at the moment that is only available as a one month injection, my docs and insurance company decided a 6-month shot of Eligard would be best for me..Only 4 injections instead of 24...Eligard is just another name for Lupron..No Casodex..I asked "what about the "T" bounce?? Doc said enjoy it while you can..My wife, who was sitting there, said something obscene...

Snowing and 25 degrees in Denver now, they say down to Zero tonight,..I think we will head South for a couple of weeks...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 11/24/2010 3:23 PM (GMT -6)   
Good luck with the HT. Hope everything goes well for you.

I'm with you on the going south idea, but I'll just have to think warm thoughts.

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 11/24/2010 3:27 PM (GMT -6)   
Hello Fairwind:
 
I too am starting HT.  Started casodex last week for the next four weeks.  At the two week mark,  Nov. 30th, I will experience my first injection of zoladex and thereafter every three months.  Should be an interesting experience.  Since we are beginning at roughly the same time with our HT, it would be good to hear from you as to how you are progressing.  My doctor wants to try intermittent HT later on but we'll see how this goes.  All the best to you and please keep in touch.  My e-mail is also posted.
 
Jack
Age 59 at Dx
01/08 PSA 4.17 with node on prostate(doubled in a year)
03/08 RP - PSA 0.0 for one year
Total ED / pump / pills no effect
09/09 RT PSA .14 / 36 treatments
Total ED / pump / pills no effect
08/10 PSA .6
10/10 PSA 1.67
08/11/10 PSA 3.44 HT recommended asap
16/11/10 Casodex for four weeks
30/11/10 First injection Zoladex

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 11/24/2010 3:40 PM (GMT -6)   
Fairwind,
 
Best wishes for the HT.
 
Just came down from the mountains, it's snowing pretty hard up there.
 
I'm switching insurance carriers (leaving Kaiser) and will need to find a PCa doctor.  May I ask where you go? 
PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09

Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.

ED - Trimix works well; levitra @ 90%
PSA - 7/31/09 <0.06; 12/1/09 <0.06; 3/29/10 <0.06; 8/4/10 <0.06

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/24/2010 3:48 PM (GMT -6)   
fairwind,

good luck on your ht voyage. please post regular on the subject, as you feel changes and what side effects
you may encounter. more importantly, hope it does the trick.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 11/24/2010 4:14 PM (GMT -6)   
Fairwind,

Good luck with the HT. But like the doc says, enjoy it while you get the bump because in a couple of week that will be all over. Hope it all goes well.

I spent last week down on Ossabaw Island, heritage preserve island off the coast from Savannh. When I returned home Monday the temperature down there was in the 80s. Not bad here today in the upstate of South Carolina either, close to 70 degrees and clear sunny skies.

Sancarlos
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2009 + ADT3 (Lupron + Casodex+Avodart) + IMRT on Novalis, 45 gy, 3/2010.

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0
12/2009 -- 0.56
5/2010 -- 0.15
8/9/2010 -- 0.06
11/2010 -- 0.013

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3781
   Posted 11/24/2010 5:08 PM (GMT -6)   
RCS, I'm on Medicare, chose "Medicare Advantage" over regular Medicare..With Medicare advantage, a private insurance company manages your insurance..Mine is AARP Secure Horizons Plan 2, an HMO type plan..But in Denver the "group" is large and I have adequate choices..My primary care Doc is a member of the group..For PC, a treatment center called TUCC has done most of it, although I jumped ship over to St Anthony's Hospital and their Radiation Oncologist (and their brand-new equipment) for my radiation treatment... TUCC is a one stop shop with about 15 U-docs, a couple of surgeons, a few R-docs, complete blood lab, imaging, re-hab, research, clinical trials, everything under one roof..While my surgery did not turn out as I hoped it would, I have no real complaints about them. We all get a touch of "The grass is always greener on the other side of the fence....."

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4235
   Posted 11/24/2010 5:53 PM (GMT -6)   
Fairwind,
Good luck on your HT. The PCRI website has a lot of articles on side affects and how to manage them. I would be concerned about your doc not giving you Casodex first. Did you ask him about ADT3 instead of just Eligard? Everything I have read says it's more effective than just a single blockade drug.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4108
   Posted 11/24/2010 6:26 PM (GMT -6)   
Fairwind,

Best of luck to you on the HT trip. I know you hoped not to have to go on this road. Be it as it may we are all here wishing you well.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 11/24/2010 7:08 PM (GMT -6)   
i had a dream last night that i had an erection.  but it was just a dream cool
 
i had my 3-month post IGRT consultation on monday.  the side effects of the seeds and IGRT seem to be gone.  i think the remaining side effects i experience are from the lupron.  i had my last 3-month shot on sept 14.  i am having moderate hot flashes whereas with the two earlier shots i just got hot at times and didn't tolerate heat well.  i have joint stiffness primarily in my hips and shoulders but i weight train and do about three hours of the bike a week.  my aching hips have me walking around like fred sanford at times but i have been hitting the bike pretty hard.  aleve really helps.
 
if you start gaining weight don't sweat it.  there will be times when your appetite just goes crazy.  i am now back in a mode of just not gaining any more weight...and i've dropped a couple of pounds in the last week.  still i'm up 23-24 lbs and it bothers me alot.
HT symptoms are all over the map.  when this last shot was  at its peak i would get severely nauseated in the late mornings for 20-30 minutes.  i pulled over once because i thought i would hurl, and i have only thrown up once in the last 21 years or so (bad food).  chewing three antacids helped alot.  i remember with the first shot i was hit with a bolt of indigestion twice that felt like i was hit with an ax below the sternum.  again antacids helped and i now carry them in my truck. 
 
my personality hasn't really changed though i am more withdrawn and i don't pursue my hobbies.  i have developed new interests tho.  intimacy with my wife is at an all-time high but sex is completely gone.  it's alot harder on her because there is absolutely no desire on my part.
 
Fairwind, i think you'll do fine. 
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3781
   Posted 11/24/2010 7:39 PM (GMT -6)   
John, my surgeon / U-doc said "If we thought you were metastatic, I would have certainly started you off on Casodex but I'm pretty sure yours is localized so doing the Casodex is really not necessary..My R-doc, from another shop, did not request the Casodex in his treatment plan..As the U-doc walked out of the room, he said enjoy the next week because the next two years will be a little rough...My wife offered a ribald comment...Friday, I think we will head down to our fishing camp in Mexico and unwind for a week or two..You guys have really been GREAT, a BIG help to me, HW is an amazing place.. Bob.

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2670
   Posted 11/24/2010 8:05 PM (GMT -6)   
Fairwind,
Good luck and best wishes for a Happy Thanksgiving.  I hope the new series of treatments goes well. 
 
We're at my daughter's for Thanksgiving and having a great time with the grandkids, but I'm sort of miserable with a stiff neck that's been going on for nearly two weeks.  A year ago, I would have shrugged it off as a pulled muscle, and I suppose it is, but since the PCa diagnosis there's the nagging thought, "Could it be cancer related."  PCa really sucks!  I nearly went to a chropractor today, but then found myself wondering if he'd even want to do an "adjustment" if he found out I just had PCa surgery. He might want x-rays and the whole nine yards.
 
Still, tomorrow's going to be a great day, and I offer Thanksgiving wishes to you and yours and to all the folks here on HW.  Bill
 
 

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1149
   Posted 11/25/2010 7:01 AM (GMT -6)   
Fairwind,

I hope that you find that this treatment goes well for you and that the side effects are tolerable.
I have read your posts on various topics and have noticed how your knowledge of this disease has grown in leaps and bounds over the last 3 months.

I wish you all the best of luck and enjoy Mexico!!

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/25/2010 9:29 AM (GMT -6)   
Best to you Fairwind I remember my ADT(3) well from the past.....you have my simpathethic understanding of those side effects. Now my humor added which I believe you can handle it.....at this stage you and others (like myself) have just entered the Twilight Zone of PCa.  Eventually fiction looks more understandable than trying to figure out the nuiances of living in the 'Limbo Land' as to where do I (we) stack up, precisely in this  current PCa scenario.  I am coming up on year 9 in the Spring and didn't think it would be this controllable in my case.  Hang in there and probably start concentrating on enjoying and forget the P.I.S.S. (psa-  intermittent- stress- syndrome), that is easier said than done of course.
 
 
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/26/2010 11:45 AM (GMT -6)   
 
Fairwind,
 
Good luck with the HT I am very interested because I will probably be going that route come January.  I will be following your posts trying to get my mind around the treatment and side effects. 
 
Jerry1

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 11/26/2010 12:16 PM (GMT -6)   
Good luck, I hope it will be an easy process for you.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 11/26/2010 12:30 PM (GMT -6)   
Hi Fairwind and Principal

Wishing you luck on this ADT route. I too started HT this month. Eligard 45mg 6-month depot preceeded by Cyproterone 2x50mg/day for one month. So far so good. Cyproterone acetate is also good for hot-flashes, a side effect of Eligard.

All the best.
Baptista
Age: 50 at Dx on May/2000; PSA=22.4;
6x cores biopsy positive; Gleason score (2+3=5)
RP in Aug/2000, PSA=24.2
Negative S-vesicles & lymph node (9); capsular penetration
Voluminous Adenocarcinoma, well-differentiated, Gs (3+2=5); pT3apN0
Post-op lowest PSA=0.18 on Oct/2000; Classified as Micro Metastasis
Jan/2001 PSA=0.26 Biochemical recurrence
AS (Watchful W.) until PSA=3.80 on Oct/2006; MRI & Bone scan negative
Nov/2006 SRT (3D IMRT; 68Gy / 37 fractions)
Feb/2008 lowest nPSA=0.05
May/2009 PSA=0.26 Biochemical recurrence
Oct/2010 PSA=0.95 (doubling at 9.6 months)
Nov/2010 ADT Cyproterone 100mg/day + Eligard 45mg 6-month depot
Asymptomatic, never incontinent, ED since RP

mycroft
Regular Member


Date Joined Oct 2010
Total Posts : 54
   Posted 11/26/2010 5:04 PM (GMT -6)   
Fairwind said...
I went in this morning to start my 2-year run on ADT...They took blood for another post-op PSA and "T" level also..I thought I was going to get Firmagon, but since at the moment that is only available as a one month injection, my docs and insurance company decided a 6-month shot of Eligard would be best for me..Only 4 injections instead of 24...Eligard is just another name for Lupron..No Casodex..I asked "what about the "T" bounce?? Doc said enjoy it while you can..My wife, who was sitting there, said something obscene...


If I understand correctly, you had a RRP a couple of months ago, and already must resort to second-line tx. What I do not understand is why the uro, who is no more than a surgeon, has not referred you to a cancer specialist, an oncologist.

That joke about enjoying the T bounce speaks ill of his professionalism. First, it's correctly referred to as "clinical flare." Second, this is the flare of T production caused by the initial dose of an LHRH agonist such as Lupron in its various guises, Trelstar and Zoladex. It can be very dangerous.

See: www.prostate-cancer.org/education/andeprv/Clinical_Flare.html

I recommend that you seek the aid of an actual cancer specialist, a medical oncologist; preferably one who is well-experienced in tx of PCa. The surgeon has done his job and IMO is no longer relevant.

Post Edited By Moderator (James C.) : 11/27/2010 4:16:55 PM (GMT-7)


Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 11/26/2010 6:13 PM (GMT -6)   
Fairwind (and mycroft):
 
It's my understanding that both your uro and rad. oncologist recommended avoiding the casodex which could prevent the "T Flare" Is this correct?  My rad. oncologist recommended casodex and zoladex for the rest of my life.  My uro recommended casodex to avoid any flare for two weeks prior to my first injection of zol. continuing casodex for only two more weeks following.  He also recommended intermittent therapy. He  made it clear that we should try this approach first. I chose to continue with my uro as I also felt this same way.  I was not too comfortable with the life sentence my rad. oncologist recommended.  With due respect to both,  I feel that I am far more knowledgeable now at this stage in my treatment,  being third line, than when I began treatment since my dx in 2008 and have started to take more control of what or how my next treatments will be or occur.  Of course I am always cautious not to take on "healing myself". 
Baptista and Fairwind, all of the best to you both and let's be in touch with regard to side effects experienced as we travel this scarey road.
It is great that I was able to find this valuable forum.
Jack
Age 59 at Dx
01/08 PSA 4.17 with node on prostate(doubled in a year)
03/08 RP - PSA 0.0 for one year
Total ED / pump / pills no effect
09/09 RT PSA .14 / 36 treatments
Total ED / pump / pills no effect
08/10 PSA .6
10/10 PSA 1.67
08/11/10 PSA 3.44 HT recommended asap
16/11/10 Casodex for four weeks
30/11/10 First injection Zoladex

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 11/26/2010 7:07 PM (GMT -6)   
Fairwind said...
I asked "what about the "T" bounce?? Doc said enjoy it while you can..My wife, who was sitting there, said something obscene...
Here's hoping that all goes well.... 
 
"T" bounce - and the bride is worried ?    
I am WAY over normal and like all the rest, it does me no good.  So much for bloody "Nerve Sparing"..
Oh, how I wish I could pose a threat ! rolleyes
 
Perhaps the Onc's have a different leaning on the   "Nerve Sparing " issue.
Perhaps they mean that the women have THEIR nerves spared after an RP..!
.
.
Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3781
   Posted 11/26/2010 10:20 PM (GMT -6)   
That joke about enjoying the T bounce speaks ill of his professionalism. First, it's correctly referred to as "clinical flare." Second, this is the flare of T production caused by the initial dose of an LHRH agonist such as Lupron in its various guises, Trelstar and Zoladex. It can be very dangerous.

Dangerous HOW?? The link posted will not open..(for me)..I think what he meant is that a little extra testosterone for a few days won't make enough difference to worry about..The ADT is an add-on to SRT...

I am very much aware of the Urologist / Oncologist cross-over point..I needed to get on ADT NOW, and having my surgeon do it was the quickest way..I don't believe he put me in any danger..

Other opinions..?
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 11/27/2010 2:00 AM (GMT -6)   
my insurance paid for everything; i didn't have a single copay for any treatment.  my doctor never mentioned flare and just gave me lupron shots.
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/27/2010 12:23 PM (GMT -6)   
All docs are experts on anything and anytime-LOL!  They trust you won't question anything!   
 
I could be wrong, I could be right.....now it is your turn on your own case.

Post Edited (zufus) : 11/27/2010 10:29:41 AM (GMT-7)


mycroft
Regular Member


Date Joined Oct 2010
Total Posts : 54
   Posted 11/27/2010 2:29 PM (GMT -6)   
Fairwind said...
It can be very dangerous.

Dangerous HOW??

The link posted will not open..(for me)..


Dangerous because it advances development of the PCa.

The link should work by copying and pasting to the address bar.

Otherwise, go to the site of the Prostate Cancer Research Institute and search on Clinical Flare: A Crisis That Can Be Avoided

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 11/27/2010 2:42 PM (GMT -6)   

Fairwind:

"T Flare" in itself is dangerous so trying to avoid it by setting up a casodex blockade will certainly allow the HT injections to carry on from there.  Question again and again.

Jack

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