Short term, low dose (50mg) Casodex

Yes. I have been on Casodex 50mg for 4 months now and have one month left. I was started on it to get PSA down in prep for radiation. I also get lupron but the goal was 0.5 PSA to start radiation. It is 1.07 now and stated at 33. In the beginning it cause bad constipation but that has stop and not having any side effects. Feel lousy but do not know what to blame it on. My Casodex is only temporary.

I was on casodex for 9 months; three months before treatment to shrink the prostate and three months after to stabalize the prostate. PSA went from 40 to .02 in three months. Side effects were a loss of libido, but could still get errections. Hot flushes about 2 per day for about 5-10 min. All side effects gone in 2 months after stopping. you should have no problem with being on it only a few weeks. My prostate went from 60 cc to 32 cc so it definately works.

I was on Casodex -- 50 mg once per day --for three months during, and for a few weeks after, SRT. My only side effect was that my nipples became slightly sore during the third month and for a few weeks after I stopped taking the Casodex.

You might find this informative..

http://www.netdoctor.co.uk/cancer/medicines/casodex.html

Some pluses with casodex, cheaper (generic is really low priced), lesser overall side effects than Lupron, (i.e. less of bone density loss and memory loss....I believe). Can be stopped, started and even revisited later and sometimes even after failing psa control, might work again later as the AR receptor seems to morph or have changes. Strange also is why you watch your psa numbers closely, if you have a significant psa increases at some juncture while on this drug (you might have an AR receptor that allowing PCa to increase...i.e. it feeds PCa and if and when this happens, going off of it can give you lower psa's thereafter (twilight zone stuff), called AAWD (anti-androgen withdrawal). Some guys have failed on this and switched to similar family of drugs called nilandron and eulexin and somehow got a new lowered psa response....so pathways and receptor methods have something happening apparently.

So, you can probably tolerate the side effects but expect to see some sooner or later. Our H.W. friend 'Ohio State' had a psa of well over 130 level and no docs giving him anything, they wanted to do proceedures on him and give him Lupron and he didn't want the Lupron or the huge treatments offered. He did 100mg casodex for awhile, then went to 50 mg and did this for about one year. His response was terrific and psa went super low and held well enough that he has gone like 2 yrs. off cycle and no drugs used, currently he just resumed taking it as his psa rose enough to be of concern (but under 10.0). We presume he will again have success with this, how long is the real question and then he can switch to other things thereafter.

Post Edited (zufus) : 9/8/2012 2:33:12 PM (GMT-6)

My RO told me two years ago that Casodex is more widely used in Europe than in U.S, but he is a big fan of Casodex because it has fewer/lesser side-effects than Lupron and you can always move up to Lupron later if needed. And based on his understanding -- two years ago when he put me on Casodex during my SRT -- there is little likelihood of decreased overall survival from going with Casodex at least in the earlier stages of treatment. So his position was that Casodex offered some benefit without the quality of life side effects of Lupron, at least as in interim step. I'll be seeing him again in January and am curious to see what he says about possible next steps if my SRT turns out to have failed.

Bohemond said...
My RO told me two years ago that Casodex is more widely used in Europe than in U.S, but he is a big fan of Casodex because it has fewer/lesser side-effects than Lupron and you can always move up to Lupron later if needed. And based on his understanding -- two years ago when he put me on Casodex during my SRT -- there is little likelihood of decreased overall survival from going with Casodex at least in the earlier stages of treatment. So his position was that Casodex offered some benefit without the quality of life side effects of Lupron, at least as in interim step. I'll be seeing him again in January and am curious to see what he says about possible next steps if my SRT turns out to have failed.

It always amazes me when I hear some of these professional opinions "after the fact". I don't regret(only because I've been fortunate) any of the choices I've made in my treatments, but I have moments when I get pissed(for lack of a better word) at the "lack of information" that most men have(depending on where you live and the professional opinion you happen to get) when faced with such life changing challenges.

Been taking 50 mg of bicalutamide + 500mg of pomegranate extract daily, for just under 8 weeks now.

Some here strongly questioned the "why" of my oncologists prescription - guess meaning "why only" - and while I read many posts here for due consideration, I will follow my docs lead and advice...


Today will get results of updated ctscan and psa blood tests.

__

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/10 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa 1.5…7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Present: taking 50mg Casodex (Bicalutamide) for 6-7 weeks before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 to meet with oncologist(s) to review results..

Hey foxrun,

Just back with really encouraging results - psa dropped from 2.0 to 0.2; ctscan showed significant improvement in the lymph gland - so I will continue same treatment regimen for next 90 days...

Bridgewater

__

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/10 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa 1.5…7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Prescribed 50mg Casodex (Bicalutamide) for 6-7 weeks + pomegranate extract before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 results indicate psa drop from 2.0 to 0.2; ctscan shows significant improvement in lymph gland...to continue same regimen for next 90 days.

FoxRun?

There was no specific differentiation today - just a review of the current good test results, discussion of any side effects and my exercise regimen + general health, etc. I did have a liver blood test when departing since the bicalutamide can affect some people harshly (like 1/50) - and alcohol, (beyond an occasional pop) is a no-no when taking this drug.

Interesting is that my lead doc here is the chief prostate medical oncologist at a major Boston hospital and from our very first meeting he told me to get on the pomegranate either by drinking the juice or getting the extract. I thought that was cool coming from him BTW, but then again. all my docs at this excellent hospital have been very forward and innovative with me from day one back in 2009.

At that point, I was just starting medical onco and we had some additional tests, etc. to complete, (see my profile timeline below) - so I was only taking the pomegranate extract, (alone), for a couple of weeks...

Later when he prescribed the casodex (generic was a-ok), I told him I had been taking the extract @ 500mg daily he said that was fine, and to continue.

So that is about it - for now, anyway, this seems to be working and I will continue with the same course of treatment. In December, I circle back with the team of oncos, do yet another psa test and we will then see where we are at - as I often say "the adventure continues".

Hope this helps...
__

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/10 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa 1.5…7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Prescribed 50mg Casodex (Bicalutamide) for 6-7 weeks + pomegranate extract before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 results indicate psa drop from 2.0 to 0.2; ctscan shows significant improvement in lymph gland...to continue same regimen for next 90 days.

Bridgewater said...
FoxRun?

There was no specific differentiation today - just a review of the current good test results, discussion of any side effects and my exercise regimen + general health, etc. I did have a liver blood test when departing since the bicalutamide can affect some people harshly (like 1/50) - and alcohol, (beyond an occasional pop) is a no-no when taking this drug.

Interesting is that my lead doc here is the chief prostate medical oncologist at a major Boston hospital and from our very first meeting he told me to get on the pomegranate either by drinking the juice or getting the extract. I thought that was cool coming from him BTW, but then again. all my docs at this excellent hospital have been very forward and innovative with me from day one back in 2009.

At that point, I was just starting medical onco and we had some additional tests, etc. to complete, (see my profile timeline below) - so I was only taking the pomegranate extract, (alone), for a couple of weeks...

Later when he prescribed the casodex (generic was a-ok), I told him I had been taking the extract @ 500mg daily he said that was fine, and to continue.

So that is about it - for now, anyway, this seems to be working and I will continue with the same course of treatment. In December, I circle back with the team of oncos, do yet another psa test and we will then see where we are at - as I often say "the adventure continues".

Hope this helps...
__

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/10 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa 1.5…7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Prescribed 50mg Casodex (Bicalutamide) for 6-7 weeks + pomegranate extract before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 results indicate psa drop from 2.0 to 0.2; ctscan shows significant improvement in lymph gland...to continue same regimen for next 90 days.

Good stuff.....thanks!

A Yooper, please keep us posted!!