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ZOLADEX INJECTION - anyone done HT treatment?

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Posted 6/16/2013 4:23 PM (GMT 0)
Hello,
Tuesday is the start of the HT Zoladex injections. Have been on tablets for two weeks to prepare for HT... for the one year.
Has anyone taken this and we wondered how you found it
Did it hurt getting it
did you get it once a month or every three months
and any side effects such as ED, pain, hair loss, bone loss etc....
Thanks all
Posted 6/16/2013 5:05 PM (GMT 0)
Many of us have done this or other LHRH types of drugs (the family: Lupron, Trelstar, Eligard, Zoladex, and GnRh Degarelix). Typically all LHRH are very similar is all the side effects (see the internet for the whole lists), but they do create bone loss over time, memory loss, consider weight gain, muscle atrophy, and the annoying hot flashes and sweats (although these might not happen right away, by 1 year you should know what types of effects you are going to experience on your own annoyances).

Zoladex is a tiny like pellet subcataneously injected into belly fat area (nice black and blue spot for 1 month is common), cheaper usually than equal coverage/dose of Lupron (the king of sales around 75% of market share-fyi). Eligard it is possible to get 1 year implant (stick like pellet) if wanting such. Lupron or Zoladex you can get various doseages from 1 month, 3, 4 month and such. Nicely profittable for the docs and uro-docs. There are other drugs you can use to combast these side effects or just live through them like many of us have done. There are other choices you can switch to later, even if they are not mentioned to you. It shouldn't be painful getting the injection, but it could and might feel like a bee sting or sore area for a few days, how it is prepared and injected makes a difference too.

You will feel fatigue with this drug, your casodex pills you used can even be used without this drug as some patients have done, sometimes used together in combo as ADT2. Many ways to fight PCa overall. Watch for your nadir (lowest) psa level, might take 2-3 months on these types of drugs, it is a prediction tool for future freedom of recurrance or progression. It is scary cause you have not tried it, after you do it then you realize it is not the biggest thing in the world, still not fun though.
Posted 6/16/2013 5:38 PM (GMT 0)
Thank you Zufus
Posted 6/16/2013 9:50 PM (GMT 0)
Hi Canuck77

I have been getting my Lupron (Zoladex) every 3 months since July 2010.

My doctor injects me with a small amount of anesethetic first, he gives me the injection in my stomach about 75mm from my navel. The Zoladex injection, whilst it is a huge needle I don't feel a thing and don't have any pain etc after. The only thing is I generally have a 25mm diameter bruise for 3-4 days after the jab. It is really no big deal getting the injection or after. The seed is about the size of a grain of rice.

I have a bit of muscle (fat !) in my stomach to help act as padding.

The side effects however, are very debilitating. I suffered the following, Hot flushes (flashes), erectile dysfunction, fatigue, weight gain (or inability to loose weight) decreased sexual desire, mood swings, very emotional and weepy, loss of muscle strength, short term memory loss, increased blood pressure, change in body hair (I have far less hair on my arms, legs and body trunk but I have regrown hair on the top of my head !), depression, some development of breasts. Concentration is also a problem, insomnia. Most of these SE became evident over the first 12 months or so, progressively I became accustomed to some.

I still suffer from ED, hot flushes, fatigue, decreased sexual desire, short term memory loss, I am still moody and emotional, concentration is still a problem.

My blood pressure took about 12 months to get under control and was good for a couple of year but is now on the rise again so looks like I will be having some close monitoring by my doctor to get it back under control. My cholesterol is also on the increase again, this will also mean tweeking my medication.

Good luck.

Posted 6/16/2013 10:49 PM (GMT 0)
THANK YOU RANGERTUG
Your feedback is wonderful. Thank you for sharing. It sure sounds like a lot of SE. We were wondering if it will effect me at work as i do some lifting but also a lot of math measurements. It a long 8 hrs if fatigued.

Do you recall how many months or weeks, when you notice the changes starting? such as fatigue, weight gain, muscle loss and the ED?

Did you have any radiation as we start in 2 months, they are waiting for the HT to shrink the PC tumour some.

Thanks again for the great feedback and wishing you well
Posted 6/17/2013 12:01 AM (GMT 0)
I've been on the four month Lupron, same family, for over six years now. I prefer the 4 month as it is no more painful and less hassle than the 1 or 2 month. I am assuming that you are covered by insurance, my Lupron shots are around $14,000 each time . . . that's $42,000 p/year. Advise to administering nurse: make sure she mixes up the batch for a minute or more, it is in two self contained pooches and the mixing both liquified and warms the solution. The needle is about 2" long and penetrates the fat of the butox. The zoladex is per Zufus' post. As long as the nurse is competent, there shoul be little or no pain on injection though I do have a tender golf ball size area for 3-4 days.
The SEs are dependent upon the individual, I am one of the unlucky ones that seemed to get them all. Ranger was spot on on his description. you won't like to hear this but for me, the fatigue is the worst of the lot. SEs show up in stages as a norm, starting with hot flashes for me. They are annoying but bearable. The worst part is they make cuddling uncomfortable, best of luck . . . Q
Posted 6/17/2013 12:23 AM (GMT 0)
Thank You Quincy
Great info. Thank you for sharing
We were wondering if the fatigue started right away or took a while to happen? Trying to plan life at work.... off if i need to go on medical leave earlier than the start of radiation etc
Hard on wife, ED and too hot for cuddling and moodiness on top of that. Knowing the possible side effect does help us to be prepared, so thank you
Going take it one day at a time
Best of luck to you too.....
Posted 6/17/2013 12:32 AM (GMT 0)
Hi Canuck77,

I work full time and usually have a fairly hectic day, I am at work around 7am but have a 45 minute drive to work, lunch is usually eaten on the go and I finish around 5.30pm, the drive home is about an hour. I know these hours don't help with the fatigue, come 8.30/9.00 I will doze off to sleep in front of the TV much to my wife's horror and could sleep until 1am and then I am awake for an hour or so before going back to sleep. Some nights early after I started Zoladex I would be awake until 3-4am before I went back to sleep. I did often sleep on the lounge in the TV room because I could then easily turn the TV back on when I woke up. It is very difficult on our relationship.

Early afternoon is also a danger time for wanting to doze off, I have to be careful at meetings in the afternoon.

Regarding the SE it really took a couple of months for them to start, the hot flushes were the first to start and I found them happening  within weeks of the first injection. The ED was about a month.

My blood pressure was progressive over 3-4 months and took about 12 months of trial and error to get it down to acceptable levels, I also had to monitor my BP morning and night because of the bypass surgery I had at the end of August 2010. I now only take my BP every morning.

Not everyone gets all of the SE and you may find that you have a different level of reaction than what I do. The hardest are the emotional and the depression, I still take medication for depression. I went to a cancer counsellor for my depression. I was very withdrawn for 6-8 months after my diagnosis and starting HT. I think I am still more withdrawn than prior to diagnosis.

I haven't had any other treatment, Cosudex for 30 days to start, Zoladex 10.8mg at 15 days and then 3 monthly. My PSA was 200 when diagnosed 1st July 2010 and Gleason 5+4 and 4+4. The PC had metastized to my bones and lymph nodes. My ADT or HT basically started to fail after 8 months when my PSA got down to 3.2 before starting to steadily rise again.I basically was classified as castrate resistant after 8 months.

I joined the Prevail clinical trial for MDV3100 in December 2011. This hasn't really effected my PSA as it has been slowly increasing since December 2011, however, CT and bone scans have shown a retraction of the PC. I am still in the trial and there hasn't been any change in my PC in my bones since May 2012.

So far I have been very fortunate, I am not in any pain and really would not be aware I have PC except for the urinary and the SE of the ADT. The urinary side has now been fixed, I have had 2 Holep operations to relieve the pressure/restriction on my urethra where it passes through my prostate.

Another SE which I forgot to mention is penile shrinkage. This has been unbelievable, my penis is now probable the same size as when I was a 10 year old. My uroligist told me I was imagining things ! I can assure you this is not something you imagine. I have since changed urologists. Not that I need to see a uroligist at the moment, I am now under the care of an oncoligist.

I am sure penile shrinkage, inability to get an erection, no sex life are some of the things that contribute to a male's depression. They are all very hard to accept. But at the end of the day I am still alive and able to basically do anything but with a little adjustment.

I wish you well in your journey and fight.

 

Posted 6/17/2013 1:02 AM (GMT 0)
(On Lupron, one 6 month shot Sept 12, did not do the Mar 13 shot)

SEs started +/- Nov. Hot flashes are different than others describe. Sweats happen, but uncommon. More often the sensation of a heating blanket between my muscles and skin - intense heat inside, skin is red, but not hot to the touch. Ice packs help.

All the rest of the SEs followed by Jan. I have them all, plus the bone joint pain from the Prolia. Even my teeth hurt when I eat. 

I can't sleep because of the constant flashes, so stay away from meetings. A/C and fans don't help much. I just literally drop in place from exhaustion and the old RT fatigue. The two together are really something. Freaks everyone out, they try to call 911 (EMS). Heavy impact on work, as I can't remember what was said in the same meeting 20 minutes before.

Libido loss is total. Complete. I'm nine months out from my six month shot, and I would much rather spend a day at the range than a night with a good-looking woman. Brain fog leaves me having to repeatedly check what is in my grocery cart, as I can't remember if I've picked something up.

I have to pay bills at receipt now, otherwise they get lost (not good).

Sucks, all told.

Posted 6/17/2013 1:41 AM (GMT 0)
Hi back atcha, fortunately, the fatigue didn't get bed but jut slowly over the first two years. I found that. light physical exercise like walking Orr gardening helped. The mood swings are like menopause, I found myself crying at chick flicks,lol and any sad news,that's easy to take. I never got rages but I would suggest seeing a psychiatrist about an anti depressant. I've been on Cymbalta for the whole stretch and find that it helps. with the neuralgia that is sometimes present. I also have found that the Lupron made my already present osteo arthritis much more aggressive along with hyperalgesia which is set off by any minor pain turning major. this didn't show up for four years so as you mentioned that you might only be on ADT for a year I think, you will probably avoid all these SEs. even though I am now bedridden about 80% of the time I am still positive and have no thoughts of giving up. that's the real trick to fighting this beast, positivity in heart, mind, and spirit. . . Q :-)
Posted 6/17/2013 2:21 AM (GMT 0)
Quincy - Thanks for the feedback
we are sending you positive healing love and light - from Canucks's wife
Posted 6/17/2013 3:23 AM (GMT 0)
good prognosis folks, we send you our blessings and healing thoughts your way, and the best of life and luck too of course . . . Q
Posted 6/17/2013 4:27 AM (GMT 0)
Hello Canuck77,

I am coming up on the end of my first year on similar drugs. My first 3-month shot was Lupron but, at the insistence of my insurance company, my doctor switched to the similar, but cheaper drug Trelstar. I am also on Bucalutamide (Casodex) which I think you also take, and I am on Avodart (a third drug). My HT is called ADT3 because there are three drugs combined.

I have one year to go on the drugs (which I am taking to make my radiation work better, same as you) and then I expect it will take another year for the effects of the drug to wear off. Since you are starting your one year about the same time as I start my second year we will reach the end at about the same time. (You are younger and only doing a single year so you may beat me to the other side. The longer you do HT the slower you recover.)

My symptoms (so far) are total loss of libido, depression, total ED, some struggle with my weight, loss of body hair, moodiness and, as someone else has mentioned, growing hair on a bald head. (My wife wants me to shave off the hair which is growing in as tufty cancer-hair but I am curious about it and will let if grow for a while to see what it does.) I also have occasional warm moments which may be very mild hot flashes but which, candidly, don't bother me very much.

During my radiation treatments I also had fatigue. It wasn't particularly bad -- I didn't miss any work but my wife had to tell me how television shows ended because I would fall asleep during who-dun-its and shoot-em-up shows and would need her to tell me the endings. At first she would rewind the shows on our DVR and show me the end again but I would just fall asleep again and after a while she just told me who the murderer was or how the hero got out of his fix and wouldn't bother to rewind.

It occurs to me that I forgot to mention that ADT has made me forgetful and spacey. I think the anti-depressant my doctor put me on has helped somewhat with this but maybe it has just made me less depressed that my brain no longer works. Hard to say. It is probably a fair statement to say that I have the attention span of a goldfish and my productivity at work is down somewhat.

I have yet to meet a man who likes hormone therapy but it is doable. You can get through a year of it OK. Bear in mind that depression is a well-documented side effect and is treatable. Don't feel ashamed to tell your doctor if you get too low -- it's stupid to drag you butt around all day when there are medicines that will help.

Good luck. Keep us posted.
Posted 6/17/2013 11:28 AM (GMT 0)
Hey Canuck77,
ADT sucks! But it is very doable! I just wanted to drop you a quick note to say to you may not see all the side effects. I so far have been handling it very well. Hot flashes are minor, libido is definitely low, and depression creeps into my daily life but is only minor. As for ED, it still works... Just takes the moon and stars to align for me to be interested. I've taken my health very serious as of late... I work out and watch what I eat. I've lost a few pounds since I started last fall, so weight hasn't been an issue.
My SRT went well and I only had a bit of fatigue in the end. I managed to work out through the entire time but did slow down a bit.
I've found the only things I can control are exercise, diet and stress. If I can stay on top of these I do OK.
All the best
Posted 6/17/2013 3:09 PM (GMT 0)
Thank You PeterDisablelard
Great info, especially about the depression and excerise and hair on head too
Posted 6/17/2013 3:12 PM (GMT 0)
Thanks 142
Posted 6/17/2013 3:17 PM (GMT 0)
Thank you TOYOUNGFORTHIS

It may be a glimmer.... but your message said there is some hope especially for the ED. The tablets didn't effect it so we have some hope already. We are really going to work on excerise, diet and stress and look for those 'moon & Stars to align.

It really helps to be prepared so we can fight and work toward these healthier step.
Wishing you best of luck..
Posted 6/17/2013 3:21 PM (GMT 0)
Did any of us mention that your testicles will shrink to the size of grapes? Because they will. That happens fairly quickly. Can be sort of disconcerting if you don't expect it. I believe they grow back to a more normal size when you get off the HT. I'll find out in 2015.

And the guys are right about exercise. It can help with a lot of the side effects. You need to be sure some of it involves some heavy exertion (not just all cardio). You need to stress your bones to keep them from losing strength.
Posted 6/17/2013 5:17 PM (GMT 0)
THANKS PETER
Posted 6/17/2013 8:59 PM (GMT 0)
Hi guys.....gona make this short and as imformative as possible.
Side effects I experienced whilst 2 yrs on zoladex......
1. Hot flashes
2.inability to fall to sleep or remain asleep
3.muscle loss
4.fat deposit around waist and chest,but no actual weight gain
5.personality change,moody tearful depressed vacant.
6.dizziness ( always around same time in afternooon)
7.loss of general strenghth.
It's do able but no fun,and I'm to start on one month shots of degrelix on Wednesday as I've had 9 months holiday from ADt and I'm feeling quite unwell now with PSA above 100.
I used the following drugs to counteract ses.......zimovane,to sleep.....cyproterone acetate,for hot flashes.....Prozac for depression.Excersise defo helps for fatigue,and sensible diet is a must to avoid excess weight gain.Penile shrinkage is due to lack of nocturnal and morning erections and I'm gona take an evening tab of 20mgs of cialis as this does not give me a headache as with Viaga.In conclusion to my short post can I say that trying to maintain a positive outlook is prudent if not always possible.I'd like to send my respect to Quincy in this post too for having the balls to remain so positive.(no pun intended).
Regards Lee.
Posted 6/17/2013 9:17 PM (GMT 0)
Thank you Lee
Posted 6/17/2013 9:51 PM (GMT 0)
Thanks Lee, even if they are the size of almonds, lol.
Posted 6/17/2013 10:15 PM (GMT 0)
Lupron ... at 6-month intervals ... is what I have been on for about 18-months with the next injection due next month. I just double-checked today at the Oncologists office, and it was confirmed that the typical Lupron dosage is about 7.5ml per month. Since I was concerned that maybe I should be having injections every 4-months - instead of every 6-months. So, as the nurse told me, it's either a 30ml dosage every 4-months or a 45ml dosage every 6-months.

Each time, I received the injection in the butt check ... so it was painless. My side-effects are a little hard to define - in view of my  other medications - but, the hot flashes (for me) just lasted the first week-end of the shot. I do believe the enlarged belly may, at least in part, be because of the Lupron. Any other side effect, like low energy level and slight abdominal discomfort, might be due to other meds.

My background - 70-years old

First Prostate cancer detection - 2004

Brachytherapy (96) + External Radiation (25 treatments) in 2004

Cancer-free (at least thought so) to 2010/2011

Casodex for a short period in 2011

Kidney affected by cancerous tumor in late 2011/early 2012

Kidney nefrostomy tubes in 2012 (both sides)

Kidney(left side) nefrostomy tube replaced with internal stent

Lupron every 6-months in 2012 to date

Zytiga from February 2012 to August 2012 - with PSA increase

Taxotere from August 2012 to April 2013 - PSA from 54 down to 12

PSA increase from 12 to 23 in next 6-weeks (with no chemo)

Xtandi is next up - starting in 3-days

Hope this helps a little for the hormonal treatment - but we all can react differently to treatments or meds .... so keep the faith!

Posted 6/17/2013 10:37 PM (GMT 0)
Well put Gizzy, what wit the kidney probs and meds it would be hard to separate the SEs of the meds. My osteo arthritis is aggravated by Lupron but to what extent I'm not sure. keep up the great attitude . . . Q
Posted 6/17/2013 11:23 PM (GMT 0)
Very useful thread for those of us that are likely to start HT soon. Thanks, canuck77, for starting it, and the rest of you for your replies. I guess it's not a pleasant thing to go through, but at least knowing some of this in advance will help.

Those of us just starting the journey can learn a lot from all of you. Thank you for sharing your knowledge and thank you for fighting the fight and showing us it can be done.

Greg.
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