Hormonal Treatment Drugs

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Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 1/24/2011 7:33 AM (GMT -6)   

Zoladex, Prostap, Decapepty, Lupron, Eligard, Firmagon

 

Can anyone inform me or can anyone tell me where to find data related to the period it usually takes to recover to normal testosterone levels, once withdrawal from above drugs?

 

LHRH agonists and/or GnRH antagonists drugs are applied for different effectiveness periods of 1,2,3,4,6 and 12 months. However, after drugs injection (or implants), testosterone returns to normal levels much later than the period of effectiveness of the drug. Some guys reported periods of 7 months since the injection of a 3-month Lupron shot but others have reported periods of 10 months since the injection of a 3-month Eligard shot. Nevertheless both drugs are made of the same leuprolide acetate protein.

Is there any correlation between the effectiveness period and the time to recover of testosterone?

 

Appreciate any post on the matter. rolleyes

Baptista


Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 1/27/2011 6:09 AM (GMT -6)   
Nobody gave me a hint on my above question in HealingWell, but I am posting here a comment I received in another forum to my question. This is important for the guys looking into Intermittent Hormonal Treatment, as it shows how long it will take to return to normal life when on Off-drug period (the principal purposes of “vacations” in HT).
The post says:

“Maybe my experience can help. The testosterone start increasing two month after the end of Casodex and it got to normal levels two months later. I was taking Lupron 4 month injection with Casodex, so testosterone start increasing six month after the Lupron shot”

This means that in his case, the normal life started 4 month after the effective end of the shot (4-month Lupron).
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

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/27/2011 6:57 AM (GMT -6)   
Hi Baptista,
I don't know how I missed your question. My experience was very similar to the other poster. I was on for 28 months. My last shot was May of 2009 and it was a 4 month depot. So in September of that year we measured my T levels and it was at 21. But then again we measured in January and my T levels had climbed to 128. Still well below normal but it was still climbing. In May of 2010 my T level was 230. At this point I started feeling more "normal" and my libido was returning. Over summer last year my hair on arms and legs had darkened back up and my hot flashes were gone.

When we had my last test in October 2010 my T levels were at 265...Still below normal so my oncologist and I did a look at my history. It turned out that before I was ever treated for my PCa my T level was 218. This means that I was suffering from hygonadism when I was diagnosed with prostate cancer. Probably the reason I was in the office for some Cialis before treatment.


Feeling good today more than a year after stopping HT. We considered adding testosterone by as my doctor said, it's risky business because I am a late stage pT3B guy. We decided to let things fly naturally.

I hope this helps...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 1/27/2011 11:07 AM (GMT -6)   
i had my last shot of lupron on 14 sept. '09.  it was a three-month shot.  i was able to achieve an erection the other night with my wife but i would not make the claim that my libido has returned.  still it was a big deal for us.  as far as i know i've never had my testosterone checked but will next week along with PSA and vitamin D.  i'm still having hot flashes tho my appetite is no longer going crazy.  in general i do feel better and my energy is a bit better.
 
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

Putt
Regular Member


Date Joined Aug 2010
Total Posts : 154
   Posted 1/27/2011 11:14 AM (GMT -6)   
During my regiment of Lupron, my T hovered between 20 - 34, depending on whether I received the 3 month or 4 month injections. Not suprised because the 4 month dose does not last for a full 4 month period. My last 4 month shot was 3/06, in 7/06, T was 34, 11/06, T was 269, 3/07, T was 386 and has remained close to that number to date. My severe hot flushes started to reduce in intensity about 6 months after my last treatment and my energy level improved. Most all of the noticeable effects were gone 9 months after the treatment was stopped. I doubt my T level will ever increase from its present level of 375 because of my age (73) but I'm glad to have it back. It looks like I will be doing it all over again before long because of the increasing PSA. What a trip this has been.....................
PSA at Dx 105 at age 68, 4/04. ADT (Lupron only), RRP, 5/04. Gleason 4+5=9, Staged pT3bc NO MO, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09, 0.30 4/10, 8/10 0.42, 12/10 47. Will start ADT3 after PSA reaches 1.2.

Arno
Regular Member


Date Joined Apr 2010
Total Posts : 54
   Posted 1/27/2011 2:39 PM (GMT -6)   
With 3 monthly Zoladex my T actually went down as low as 9 !
March'06: PSA 3.6
Diagnosed at age 63 Sep'09: PSA 575, GS 7 (4+3)
3 positive cores in 6
Bone scan: as a fully lit christmas tree
With Zoladex 10.8 mg +150mg Casodex PSA <0.1
Stop Casodex July 25, 2010 (PSA 12)
AAWR started August 20, 2010 (PSA going down !)
Additionally 4-weekly Zometa (zoledronin acid)

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 1/27/2011 3:42 PM (GMT -6)   
When discussing different treatments and therapies, my U-doc mentioned that after taking lupron or its clones for over 2 years, the effect of the drug can become more or less permanent...In a fairly large portion of men, the "T" levels simply never come back. Most men hoping for a quick recovery when HT is stopped are sadly disappointed...

Also, that lump of wax they inject into you, the 'time release" mechanism, takes a long time to be absorbed completely...This also slows down the comeback...
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
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 1/27/2011 4:04 PM (GMT -6)   
Thanks to all for the replies.
There is no data in the net or even at drug-suppliers about drugs action regarding periods which I believe could help our friends on HT. I am gathering this information and will make a resume of my findigs to post here later.
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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 2/8/2011 7:12 PM (GMT -6)   
I asked my radiation oncologist today why Urologists insist on being the ones to administer HT drugs instead of referring patients to medical oncologists..His answer was instantaneous and very telling in more ways than one. "They don't want to give up the money.."
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
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 2/8/2011 7:21 PM (GMT -6)   
i got my last shot of lupron five months ago.  it was a 3-month shot.  i saw my uro today and my T level is 6.  my PSA is undetectable.
 
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

Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 2/8/2011 7:29 PM (GMT -6)   
Thanks F8,
I am still gathering info on the matter for later posting my findings.
I am investigating in forums in other languages (Japanese, spanish and french) but cannot get what I really want.  

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 2/8/2011 7:36 PM (GMT -6)   
Baptista -- you're welcome.  please let us know what you find.  i'll update as i get results (4 months).
 
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

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/8/2011 10:15 PM (GMT -6)   

I have had one, three month injection of Zoladex.  No serious SE as of yet. Readying for my second in two weeks.  Anxious to receive report on recent blood test for PSA and T levels.  My doctor and I will be making some decisions then.

In a previous post I had mentioned that my base T level was 25 (19 -66 considered average levels by my Dr.).  How is this translated to the numbers posted on this site. ie: 240  - 800 is the normal range?


Age 59 at Diagnosis
01/08 PSA 4.17 DRE showed node
03/08 RP - Nerve Sparing, margins clear, no invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 RT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44
30/11/10 Zoladex ADT

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 2/9/2011 5:20 PM (GMT -6)   
Skate said...
I have had one, three month injection of Zoladex. No serious SE as of yet. Readying for my second in two weeks. Anxious to receive report on recent blood test for PSA and T levels. My doctor and I will be making some decisions then.

In a previous post I had mentioned that my base T level was 25 (19 -66 considered average levels by my Dr.). How is this translated to the numbers posted on this site. ie: 240 - 800 is the normal range?


Skate, there are two ways of measuring most things chemical and medical. The most widespread international method is metric (known as SI) and a very few others still use the old US system. Your reading of 25 (metric) is 720 on the old scale.

There is a converter for these different methods at the top of the page below:

www.soc-bdr.org/rds/authors/unit_tables_conversions_and_genetic_dictionaries/e5196/index_en.html#conversion

Bill

Post Edited (BillyMac) : 2/9/2011 3:24:45 PM (GMT-7)


Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 2/9/2011 6:07 PM (GMT -6)   
Yes, since June 2010, there is an new methodology for measuring testosterone regarding units ng/dl or ng/ml into nmol/L (1 nmol/L is approximately 29 ng/dl). Normal T (8.4 to 28.7 nmol/L)
In radiation therapy Gys are also now referred in Centigreys (1 Rad = 0.01 Grey or 1 centigrey).
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

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 2/9/2011 6:42 PM (GMT -6)   
 i got my results of 6 ng/dl from labcorp yesterday.  in parentheses it says that 193-740 is the normal range.
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA 0, T= 6

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/10/2011 7:42 AM (GMT -6)   
Bill:
That puts me at the top range of normal, yet my dr. stated 25 was at the lower range of normal.  Thanks for the table as it does confirm your translation.  Then, from what I read on this forum,  HT is looking for a chemical castration level of less than 20.  In what units is this interpreted?  A little confused .
 
Skate
Age 59 at Diagnosis
01/08 PSA 4.17 DRE showed node
03/08 RP - Nerve Sparing, margins clear, no invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 RT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44
30/11/10 Zoladex ADT
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