I just started monotherapy here in Japan in March of this year. Dr. Charles "Snuffy" Meyers mentioned using monotherapy with Casodex on an elderly patient who he thought would not tolerate the side effects Lupron. Usually, he prefers to prescribe a two-punch approach, Lupron + Casodex, as just one example. Other than this, in my own research I have not come across many references to monotherapy, also called "step therapy".
My doctor explained to me that monotherapy starts with a drug like Casodex and once the Casodex fails, the treatment is "stepped up" with a stronger drug like Lupron. Your husband is already taking Lupron, and for him, monotherapy with Casodex seems to be a step backward.
By all means, consult with your doctor about
the feasibility of starting monotherapy at this point in your husband's treatment.
No symptoms prior to dx.
2013/08 Routine blood test revealed high PSA of 12.7. DRE negative.
2013/11 Transurethral bx revealed cancer in 7 of 21 cores. Staged T2c (DRE negative), Gleason 7.
2013/12 2nd opinion upgraded one core Gleason 7 to Gleason 8. Surgery scheduled same day.
2014/02 Robotic RP, Tokyo Medical University Hospital. Catheter removed 8 days later.
2014/03 Post-op path report confirmed Gleason 8 and revealed up to 7 tumors ranging Gleason 6, 7, 8. Seminal vesicles and both pelvic lymph nodes removed and dissected, both vesicles and nodes were negative for any sign of cancer. One margin suspect (pathologist could not decide if it was positive, so it was judged “to close to call.”). Right nerve bundle was taken, left nerve bundle spared. Final staging T2cM0N0. Good recovery from stress-urinary incontinence after 6 weeks, pad free after two months post surgery. ED remains a problem.
2014/08 Hospitalized again to repair large hernia at ventral incision above the navel.
2014/09 PSA levels (tested every 60 days since surgery) 0.1, 0.1, 0.1, 0.2, 0.3.
2014/09 Started SRT (EBRT), 30 sessions (6 weeks), 2 gy per session. After third week of SRT, PSA dropped from 0.3 to 0.2. PSA reading after SRT on 27 Oct: 0.2
2016/08 PSA continued a slow but steady rise over 18 mo. from 0.2 to 2.0. Finally, started HT monotherapy with Casodex in Mar. 2016. PSA dropped from 2.0 to 0.3, to 0.1, and finally to <0.1
Very pleased with the reaction to Casodex, but how long will it last?
Post Edited (Yank31) : 9/6/2016 4:52:58 AM (GMT-6)