The answer is it may or may not be beneficial, especially in high risk and prior HT user scenarios, PCa morphs and become resistant is part of the problem. In some cases adding casodex later on in HT therapy or long term useage can cause it to even feed PCa and be bad news for the patient, watching psa's and blood/urine markers would tell you the biology of the disease. Those that have psa increases with casodex type drugs can also get AAWD (anti-androgen withdrawal) psa lowering effect, when quitting useage (this is the land of the bizzare).
Casodex can be used as primary HT therapy, Dr. Labrie has plenty of information on this, he is like the founder of its useage, it can be used with various drug therapies and often used along with LHRH drugs, alot uro-docs probably don't want you to try it because you may find it has lesser side effects than LHRH drugs and costs less, and no profits for the doc vs. big profits doing lupron (lhrh) injections and such. Alot of us patients don't know that a study by Wheel et at compared Lupron+casodex to Casodex+Proscar and the later combo was found equivalent in effectiveness for non-refractive or HT naivee PCa patients. The later has lesser side effects, lesser costs, lesser bone density losses, lesser memory losses, less profits for the ones pushing it (per se). You can fail on casodex and get renewed effects switching to other drugs in the same family in some cases, so nilutamide, flutamides, can and have worked well in some patients. Go figure! Casodex is also a bicalutamide (generic is much cheaper).
I just added casodex to my regimen just recently to see if psa would stop small increases or stablize it and if you know my story I am high risk from 2002 early on and done various HT therapies. Well I got a walkin psa test within 7 days after starting casodex to make sure I was not seeing an increase in psa and feeding PCa (which can happen at this type of juncture). The good news in my case right now it is apparently helpful and working my psa's were stable at .8 area for long-long time, recently though went up to 4.12, then 3.18 (2-3 weeks ago), then 2.80 after 7 days on casodex. I will retest psa within another 2 weeks at docs office and see if psa further declines appear, which it make take a month or more to see if overall decreases continue using this. If I were to see a very marked increase in psa while on it would drop it immediately. I am taking this in conjunction with my DES 1-mg which has given me fabulous results and super low side effects for like 7-8 yrs.
I don't think the docs can tell you upfront how you will do right now in using this, if they had your pathology tested for AR receptor expression information, it could be a heads up on how you might respond. If you can, try it and see...but get a psa test fast (like less than one month) to make sure it is not in fact turning into feeding your PCa.
Anyone else with experience or thoughts on this can add some to this, Ralph, Terry H. and some others would probably have something to say to confirm or add to this line of discussion.
Leeanglo- lots of possible ways to fight PCa, some people even have used estradiol patches or emcyt or other drugs as primary HT therapies with good results and never jumped into LHRH drugs or casodex, consider that a clue on there actually is lots of ways to fight this, those mentioned are just a few.
Post Edited (zufus) : 12/3/2011 8:44:00 AM (GMT-7)