Zoladex vs Lupron

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Artist Mark
Regular Member


Date Joined Apr 2016
Total Posts : 367
   Posted 9/7/2016 12:40 PM (GMT -6)   
Hi to everyone.

I am just into my second week of IMRT. I have a scheduled HT shot coming up on the 20th. My first shot was Zoladex that was given at Virgin Mason Seattle. My local uro's office called and wanted to schedule a "Lupron" injection. I've been trying to search if there are differences in the 2 shots and have found some info but not anything about changing in the middle of Rt. I would think I should stay on the same course. Maybe it doesn't matter?
Also, seems I'm getting immediate fatigue following each IMRT treatment. Dr. says I shouldn't feel side effects yet. Maybe it's in my head. My fatigue from HT usually hits mid afternoon so maybe that's just getting worse.

Anyway, thanks for any input,

Mark
Age 59
Dx 6/3/2016 PSA 3.42 %fPSA 7.6
Bx 6/1/2016 Gleason 9 ... 8 of 12 cores positive (70% - 60% - 30% - 30% )
PV=29cc
4+5 =G9 (4 cores) PNI.. present
5+4 =G9 (2 cores)
3+4 =G7( (2 cores) PNI.. present
4/2016 ct scan...neg
6/13/2016 Bone scan..neg
6/17/2016 Tx starts ... LHRH Zoladex shot
7/28/2016 Markers implanted
8/16/2016 PSA .27 T = 14
8/16/2016 PV=12cc
8/30/2016 IMRT

schoolpsych
Regular Member


Date Joined Aug 2016
Total Posts : 240
   Posted 9/7/2016 4:24 PM (GMT -6)   
Hi Mark,

I can't offer answer on the difference between the two but I wanted to say "Hang in there". I was wondering how it was going with you.
DX at age 50
July 2016
PSA at DX =47
Biopsy shows a mixture of G7 and (4+5) G9 cores. 12 0f 13 cores positive
CT Scan, Bone Scan, and lymph node biopsy found one pelvic node positive
4 month Luprun shot on 8/19/2016

Artist Mark
Regular Member


Date Joined Apr 2016
Total Posts : 367
   Posted 9/7/2016 8:26 PM (GMT -6)   
Hi there Schoolpsych.

Thanks for the check in. So far everything seems to be going as scheduled. Fatigue and hot and cold at night seem to be the worst of it. Oh and trying to make sure my bladder is full. I'm beginning to dislike water and it's only been a week! If I don't go in bursting at the seems,barely able to hold it ,I don't get it 100% full on schedule. Then I'm peeing for about 2 hrs. straight. Oh the minor discomforts.

On another front , I'm still trying to schedule with Gastro surgeon for a resection in my duodenum. Not going like I want. And the clock just keeps ticking.....

Thanks again. Hope you are doing ok, Mark
Age 59
Dx 6/3/2016 PSA 3.42 %fPSA 7.6
Bx 6/1/2016 Gleason 9 ... 8 of 12 cores positive (70% - 60% - 30% - 30% )
PV=29cc
4+5 =G9 (4 cores) PNI.. present
5+4 =G9 (2 cores)
3+4 =G7( (2 cores) PNI.. present
4/2016 ct scan...neg
6/13/2016 Bone scan..neg
6/17/2016 Tx starts ... LHRH Zoladex shot
7/28/2016 Markers implanted
8/16/2016 PSA .27 T = 14
8/16/2016 PV=12cc
8/30/2016 IMRT

Michael_T
Veteran Member


Date Joined Sep 2012
Total Posts : 3061
   Posted 9/7/2016 8:40 PM (GMT -6)   
Mark...I don't know the difference other than anecdotally based on this website, Lupron is more common. No idea if one is more effective, has a different SE profile (although I doubt that) or is less expensive.

Good luck with the rest of your IMRT!
Age 55, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
6/16: T = 162, PSA = 0.20

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 9/8/2016 12:21 AM (GMT -6)   
Mark,

I don't think it matters at all. Maybe one is cheaper though? They are both GnRH agonists. The one that is different is the GnRH antagonist called Firmagon (degarelix). It doesn't cause a testosterone surge, so it is sometimes used in guys with multiple bone mets to prevent bone pain from the surge.

- Allen
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

Chask
Veteran Member


Date Joined Jun 2014
Total Posts : 531
   Posted 9/8/2016 1:20 AM (GMT -6)   
Michael_T said...
Mark...I don't know the difference other than anecdotally based on this website, Lupron is more common. No idea if one is more effective, has a different SE profile (although I doubt that) or is less expensive.

Good luck with the rest of your IMRT!


And again only anecdotally it seems as if Zoladex is prescribed more commonly in Australia.
Age 68 at Dx
10/08 to 03/13 PSA 2.9 < 7.1
07/13 Bx 4+ cores from 12 GL 4+5 Scans clear
08/13 LRP
Path: Gl 4+3 PNI, bladder mgn +, SV, LN Neg, pT3a N0 Mx
10/13 PSA .03
11/13 PSA .07
12/13 12 month ADT
Continent
01/14 37 sess of RT
05/14 Incontinence back
11/14 Retentive due to RT nerve damage. SPC installed
12/14 ADT Break
05/14 - 09/15 PSA <.01
12/15 .01
03/16 .03
O6/16 .09

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 9/8/2016 7:28 PM (GMT -6)   
I have had excellent results with Zoladex.

Mal.
born 1940 dx 07 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 stage T2a
RP on 30th July,
Post op Pathology, stage T3a 4+3=7
Post op PSA 0.5 SRT DEc. 07 to Feb 08
PSA April o8 to Feb 11 0.5 to 0.7
July 2011 1.31 Feb 2015 6.27! Sept. 2015 11.24!! PSMA-Ct shows lymph node involvement, Started Casodex and Zoladex 12th November PSA 23rd Dec 2.0! PSA 25th March 0.03!!

Artist Mark
Regular Member


Date Joined Apr 2016
Total Posts : 367
   Posted 9/8/2016 9:33 PM (GMT -6)   
Mal,
I feel like zoladex is working good for me also. I talk to my RO after thurs treatments and she agreed. She is going to administer the injection so I will not have to deal with my urologist here in town. I'm not really happy with them anyway.

Mark
Age 59
Dx 6/3/2016 PSA 3.42 %fPSA 7.6
Bx 6/1/2016 Gleason 9 ... 8 of 12 cores positive (70% - 60% - 30% - 30% )
PV=29cc
4+5 =G9 (4 cores) PNI.. present
5+4 =G9 (2 cores)
3+4 =G7( (2 cores) PNI.. present
4/2016 ct scan...neg
6/13/2016 Bone scan..neg
6/17/2016 Tx starts ... LHRH Zoladex shot
7/28/2016 Markers implanted
8/16/2016 PSA .27 T = 14
8/16/2016 PV=12cc
8/30/2016 IMRT

Cyclone-ISU
Veteran Member


Date Joined Oct 2014
Total Posts : 1097
   Posted 9/8/2016 10:41 PM (GMT -6)   
Hello Artist Mark,

I've tried all 3 forms of ADT shots ... LUPRON, then FIRMAGON, and now I've been on ZOLADEX this past year.

My oncologist found that I was getting "spikes and flares" in my P.S.A. levels ... so we tried the different forms of ADT shots --- what we found is that my testosterone levels were spiking in between shots --- so my oncologist felt we needed to try to get my testosterone worked down to a low level, thereby helping to control the P.S.A.

In my case, we also discovered that the testosterone "spikes" were occurring during the multi-month shot dosages ---

Over time, once we switched over to monthly ZOLADEX injections, my testosterone level has consistently stayed BELOW 10, which it was not doing with the other forms of ADT shots.

ZOLADEX seems to be used more rarely --- it's injected into the abdomen --- my oncologist was very willing to see if we could achieve a better effect than we had seen with the LUPRON or FIRMAGON.

I see my oncologist every four weeks, as it stands --- so getting the monthly ZOLADEX shot in my case works out.

Just thought it would be good to know there are a few of us here on ZOLADEX injections --- plenty of fellows here on LUPRON and FIRMAGON, as well --- I've tried all 3 over the course of time now !

Hope you are doing well, Artist Mark !

Sent with my best,
"Cyclone Fan" ~ Iowa State University
PSA At Diagnosis In Year 2013 : 138
Initial Diagnosis: Advanced Prostate Cancer, With Metastases In Both Lungs
Age At Diagnosis: 48 years
ADT Treatments: LUPRON, FIRMAGON, and currently ZOLADEX
Subsequent Treatments: Chemotherapy Treatments (TAXOTERE) & now ZYTIGA
Additional Medical Consultant - Dr. Eugene KWON - Mayo Clinic
PSA Level: Currently < 0.10, With Treatments Ongoing

Redwing57
Veteran Member


Date Joined Apr 2013
Total Posts : 2500
   Posted 9/9/2016 2:38 PM (GMT -6)   
I had Lupron injections, both six month and 4 month at different times. My testosterone was well suppressed by it, below 10 any time we had it measured. Minimal discomfort at the injection site, kind of like a bruise sensation that lasted about 24 hours. Then, six months of no testosterone, yippee. If it works, I find Lupron to be a very easy method to do the awful thing we need done.

As to IMRT side effects, I don't recall how soon my fatigue after treatment began, but it happened during most of the 44 sessions. And as you say, it was instant. I'd lay on the "couch" of the x-ray machine, and 10 minutes later after the treatment session was over I'd sit up and feel.. well.. funny. And a little tired. Instantly. It was 45 minutes back to my office, and my wife drove me to and from each session. I'd nap in the car on the way back to the office for 20-30 of those minutes. I mean I crashed out about as soon as I closed my eyes. By the next day i felt fine, and we'd do it all over again. and again. and again...

My RO said you can't actually feel the x-rays, but your body senses the injury and is letting you know it in a somewhat subtle way. Oh, and to the doc saying you shouldn't feel it yet, ask him when he had his x-ray therapy that informs his opinion. I'm betting he never has, so it's just theory for him. If you feel it, you feel it.
55@Dx 4/16/13
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3TMRI: Bilateral EPE, NVB+, SV-, LN-)

Pre:
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31

Tx:
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex

Post: (age now 58)
(HT 5/13-3/16) PSA <0.1 : 8/13 - 5/16.
(no HT 3/16- ) PSA 0.2 : 8/16

Post Edited (Redwing57) : 9/9/2016 1:41:19 PM (GMT-6)


George Glass
Regular Member


Date Joined Jun 2015
Total Posts : 29
   Posted 3/8/2018 5:36 PM (GMT -6)   
Redwing57, did you start intermittent therapy or did the Lupron stop working by itself?

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6069
   Posted 3/9/2018 1:56 PM (GMT -6)   
Hi Artist Mark...are you able get any exercise...during this regimen? I realize the fatigue comes in tha latter part of the day...this I think would be "natural" I would like to suggest....if you are able...to take rambling type walks around your neighbor hood...baby steps...not so much for exercise as communing withthe life that flourishes when one is out and about...be discerning...but if you catch an eye...respond if only in your mind...it will connect...maybe get in a habit of visiting the same store and build a silent relationship...sit on a bench....empathise with the de lights of others movements and joys...children...happy/sad...Seattle is a wonderful city...not sure where you live...but you could just ride a bus...here or there....much is given...never be afraid to receive...It is a valid way to give of yourself...regards...don't fret...melt into yourself...all is well...know this...what ever the "circumstance" of the day "sufficient unto the day is the evil thereof".... deterioration follows us all closely...regardless of circumstance...keep moving in faith...soul high...logo
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...
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