Swapping ftom zoladex to cosadex as a mono therapy

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leeanglo
Regular Member


Date Joined Dec 2010
Total Posts : 191
   Posted 2/5/2011 7:46 AM (GMT -6)   
ANY veiws on going onto monotherapy with just cosadex ???
psa on dx 144, gleason 4+3 7 12 biopsie cores cancerous
T3a N2 M1.
psa after 3 months zoladex 20
T levels 0.5 after 3 months zoladex.
changing to monotherapy cosadex feb 2011.

zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 2/5/2011 8:08 AM (GMT -6)   
Casodex- can be done in 50-100-150 mg dosages. Are you with 50 mg? High doses are further risk for boob enlargement. The overall issue side effects are lesser comparatively to LHRH drugs, I would say.

Because of your risky stats and overall findings....my view is monitor this monthly for psa increases (walk in psa test places or however), in some high risk patients and depending upon prior ADT drugs like you did, PCa can turn AIPCa or HRPCa and casodex or its equivalents (flutamides), in some patients helped FEED PCa and added to PSA increases and sometimes very fast, that would be immediate time to cancel using it and some docs do exactly that. I have seen this event happen in many patients.

This is why you monitor it very closely, of course 'IF' you have a very wise oncologist...he should know all that and be working for your best interests and outcomes. You might do well on casodex, cannot be fully known. My own guess as having watched other patients throughout the years on forums, is that it may not work that long...thus another reason to monitor closely. Look at the website:    www.hrpca.org     (proven treatments) you will be looking at these for hopefully years and years, as some of the choices. Is this your choosing right now or is doc suggestings the casodex or its equals????
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

Post Edited (zufus) : 2/5/2011 7:12:22 AM (GMT-7)


Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/5/2011 8:38 AM (GMT -6)   
Leeanglo:
 
I am approaching the three month mark on Zoladex, ready for my second injection.  My uro surg had me on casodex two weeks prior to the Zoladex and two weeks after the injection ( as a blockade ) only.  May I ask why you would switch when there is such a drop in your PSA and a very low T after just three months?
Jack

leeanglo
Regular Member


Date Joined Dec 2010
Total Posts : 191
   Posted 2/7/2011 9:03 AM (GMT -6)   
HI gentlemen,thanks for your repilies.It was ajoint decision between myself and the doc to do the cosadex as wew came to the conclusion that if my psa was still 20 after 3 months then it was prudent to try something else.I am quite tolerant to zoladex but with a psa at 20 i decided to give the cosadex 150mg a go for three months and see how the psa is doing then.The zoladex in my system will still be working for another 2 months so realistically in three months time i will only have had just cosadex in my body for one month.If i can get my psa untraceable this way then i will have a better standard of life than on both meds or zoladex alone (i hope).I must say though this 150mg cosadex does make me feel lathargic so i am gona take it at night time from now on.I also start six treatments of ZOMETA infusions from next thursday and hopefully these will help my situation too.I think i also need to request another psa test when im at hospital next week to sure that the cosadex is not feeding the cancer (scary Thought !!)
regards Lee...
psa on dx 144, gleason 4+3 7 12 biopsie cores cancerous
T3a N2 M1.
psa after 3 months zoladex 20
T levels 0.5 after 3 months zoladex.
changing to monotherapy cosadex feb 2011.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/7/2011 9:27 AM (GMT -6)   
Best to you it may show good results, you have to also worry about breast enlargement especially with 150  mg useage, you can either take another drug(talk to your doc) to help prevent that or you get a radiation protocol to your breasts....usually done in 3-4 sessions, very slight time exposures and could be done with electron rays (less chance for issues). It can also be done in one session with 3.5 minutes exposure to each boob (lol). You may soon see like a sunburn spot (normal) approx. 6" diameter on them, it goes away in maybe 1-2 months and works for many patients to stop any enlargement, however if you already have enlargement there is not reversal in this.
 
Thought you might wish to know that above and this upfront.  With zometa it does help your bone density, there is also the slight worry or concern if you get jaw necrosis, as weird as that can be for using this on bone issues.
 
Knowing all you can up front is always worthwhile. cool

JNF
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Date Joined Dec 2010
Total Posts : 3651
   Posted 2/7/2011 10:40 AM (GMT -6)   
Many doctors will also add a 5 alpha reductase inhibitor like Avodart or Proscar to attack the DHT production. It is a more powerfull form of Testosterone that the drugs like Lupron, zolodex, eligard and Casodex don't reduce. I would be asking the oncologist about adding that routine.

Putt
Regular Member


Date Joined Aug 2010
Total Posts : 154
   Posted 2/7/2011 11:36 AM (GMT -6)   
Leeanglo
I don't mean to hi-jack this thread to something else, but since you mentioned Zometa, and Zufus warned about Jaw Necrosis, all readers contemplating taking any Bisphosphonate (Fosamax, Actonel, Aredia, or Zometa) should get a full dental check-up before treatment.  Root canals or tooth extractions open the possibility of infection which can develop into bone cell death which is necrosis.  My oral surgeon stated Fosamax was the least likely to cause problems, but the percentages increase with the others.  Sorry, didn't mean to butt in.
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 0.47. Will start ADT3 after PSA reaches 1.2.

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/10/2011 10:51 AM (GMT -6)   

Leeanglo,

Any updates on what you are doing?

Sk


leeanglo
Regular Member


Date Joined Dec 2010
Total Posts : 191
   Posted 2/10/2011 11:50 AM (GMT -6)   
Hi gentlemen,this thread is mainly directed to skates last post about what im upto.I took a 150mg cosadex 2 days ago and to be honest it made me feel dreadfull (zombified all day),this took me back to when i initially had 4 weeks on 50mgs prior to my first zoladex injection and even 50mgs made me feel fuzzy.Ive also had a strang feeling in my spine which i believed was tumor flare syndrome when i first took cosadex.Because it has happened again ive decided to speak to my u doc before continuing as im a little worried that this drug can be doing me more harm than good!! I eventually got to speak to another urologist today and he said i should not be experiencing this as ive had zoladex in my system for over 3 months now.My desicion is to give the tabs another try but im gona take them at night time instead and see how they affect me then.As anyone else experienced this throbbing sensation on taking cosadex with zoladex ?? is it temporary?? Its a little scary at a sight where you know youve got cancerous mets mad The u doc says hes gona get me back for another scan incase of any spinal compression.Strange thing is i had no signs of any bone incidence untill after i took cosadex, initially, and it went away after i ceased taking it.Now after taking one 150mg tab its back with a vengeance and although it is not what id call pain,it is very anoying and it makes me continually aware of my desease.

leeanglo
Regular Member


Date Joined Dec 2010
Total Posts : 191
   Posted 2/10/2011 11:59 AM (GMT -6)   
Putt, sorry for missing your point about dental procedures ect.....
my u doc made me aware of the difficulties with extrusions so i am all good in the dental department.Many thanks for your imfo though, this whole things a learning curve for us all and the better armed we are the more chance we have of longevity.
Hence any threads, replies posts,of any sort are gona help one of us here.
regards Lee..
psa on dx 144, gleason 4+3 7 12 biopsie cores cancerous
T3a N2 M1.
psa after 3 months zoladex 20
T levels 0.5 after 3 months zoladex.
changing to monotherapy cosadex feb 2011.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/10/2011 1:59 PM (GMT -6)   
Leeanglo sounds strange about the spinal type issues you say you are experiencing. You could call Patient Advocates on Advanced Prostate Cancer (PAACT) and talk to them free and mention your senario...they may have some asap advice: (Michigan) 616-453-1477 Rick Profitt likely to answer. They have decades of experience in various patients using all types of flutamides and casodex, likely seen plenty of cases.
 
If you can find a psa testing facility nearby I would get tested pretty soon and see if it helps at all and that would be a clue, especially when using HD casodex at 150 mg level. I question how useful is it and is it doing harm???  Because of your overall stats and other variables, mono therapy for someone else in a different scenario could be much different and/or work fine, so that people don't get the wrong impression. PCa can morph and/or have androgen independence and be tricky on the receptors as to what happens on a cellular level. This is why the drugs, timing and useage is very strange, some patients fail psa on casodex perhaps even early on, but later in their PCa journey cycle sometimes can revist it and get a new response....it is that strange.  Protocols are tricky and that is why the specialist rule in knowing the biology of PCa, Dr. Myers, Strum, Scholz, Lam, Leibowitz, Volgezang, Yu and some others are the best in this.

Casodex is normally not associated with any type of flaring, just the opposite. It does have possible back pain, but spinal is little different. One website mentioned this:

Musculoskeletal

Musculoskeletal complaints include bone pain. This may be due to underlying disease.

So if it were in effect doing harm for PCa, then I suppose the spinal pain would be a possible clue and might even get more painful, maybe. Like I said I don't presume to know, only to question. 

Best to you.
(suggested reading:    www.hrpca.org     proven treatments)

Post Edited (zufus) : 2/10/2011 2:49:08 PM (GMT-7)

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