..First Lupron shot Friday 08/09 @ 1PM..

 

..I will be getting another type of injection this Friday afternoon, HT Lupron.  I am not looking forward to this but yet I am looking forward to fighting the beast.  Please advise as to what will the first shot be like?  I have read a bunch about the side effects and such but how is it in the begining?  The first day/night?  The first week or so?  I have heard it takes a few weeks to kick in and or change you.  If someone would be kind enough to time line the effects & how it takes you over?  Different people fair differently I suppose.  Anyone willing to share their personal Lupron effects I would love to understand more?  Plus I am just looking for a little support cause I am scared..

...................Strength & Honor...........

...................Appleseed...Nick............

The only side effect the first day will be that your butt will be a bit sore. It took me 3-4 weeks before the side effects started...for a while I hoped somehow I was immune to them. The most noticeable are the hot flashes. At first they were amusing, but they get old real fast. Depending on how you tolerate them, there are ways to somewhat mitigate them, but they're definitely a nuisance. And then there's the lack of libido issue. That also gets old fast since you feel like a part of you is missing.

Other things like brain fog and lack of energy haven't been as much of an issue for me. I've gained a bit of weight (5 pounds), but try to exercise as much as possible to keep it off. I haven't had breast enlargement yet, but sometimes I wonder when I look in the mirror. (It's probably the five pounds I've gained.)

Despite all of this, it's a nuisance and nothing more. You WILL be able to tolerate this if you keep exercising and watch your diet. If things like the hot flashes become too much to handle, ask for help. (I take gabapentin, which helps at night.)

Are they giving you Casodex before your Lupron shot? That's common to prevent bone flare, but I've learned there's debate about how necessary it is. Of course, many take Casodex with their HT as part of their regimen.

PS Check out Compiler's diary of his hormone therapy experiences for more info.

Initial injection - the least painful shot I've ever had. Literally no sensation of it at all. I was amazed. That evening, the injection area started getting a little achy. The next day it felt like a bruise - some have called it the Lupron limp! But, that cleared up pretty much at the end of the 2nd day. After that, nothing for a while.

As others said, for the first few weeks not much happened. I was sort of hyper-vigilant, but just not much change. It's weird, knowing your body is sort of going into a limited reverse-puberty :)

After about 3 weeks the hot flashes started sputtering, and after 4 weeks they were full on. Every half hour like clockwork all day long. Recently, they've become more variable so I only notice the prominent ones, about every 2 hours. The intervening ones also happen, but I've become so used to them they just fade from awareness.

My doctors didn't want to use Casodex since I'm on HT before and during radiotherapy (the anti-androgen in this situation has little proven benefit, but has extra side effects). The flare thing is fairly controversial for this use of Casodex. However.... after 7 weeks on Lupron, my PSA had only dropped from 5.2 pre-biopsy to 2.0, even though my T level was under 20. We'd hoped PSA would go down quite a bit further than that. When my uro onc reviewed that result, he immediately added Casodex for the duration. My PCa doesn't seem to be as responsive to HT as hoped, which is sure possible considering the large amount of G5 cells I have.

I'm over 3 months into this ride. My little guy snoozes most of the time, but will respond to direct stimulation. Oddly, the boys already shrank about 50% but seem to be stabilizing there. Maybe they'll continue to shrink, but it seems to have slowed.

I have 2 years of this to look forward to.

Just know that your reactions to Lupron may, or may not be, the same as other men. One size does not fit all as to side affects for many reasons.

Dr. Snuffy Myers, a specialist in prostate cancer, has a few suggestions for this man on Lupron:

"Under Dr. Myer's direction, I used low-dose Vivelle-Dot patches (estradiol, 0.025 MG, twice per week) to minimize bone loss and hot flashes during Lupron/Casodex treatment, and my side effects were quite minimal. However, these doses are much lower than those used for primary treatment."

Some relevant articles:

J Urol. 2005 Aug;174(2):527-33.
Transdermal estradiol therapy for prostate cancer reduces thrombophilic activation and protects against thromboembolism.
http://www.ncbi.nlm.nih.gov/pubmed/16006886
Ockrim JL, Lalani el-N, Kakkar AK, Abel PD.
PURPOSE:
Oral estrogens were an effective treatment for prostate cancer but were abandoned because of an increased risk of cardiovascular toxicity and particularly thromboembolism. We have recently shown that transdermal estradiol produces an effective tumor response and negligible cardiovascular toxicity. Here we report the influence of transdermal estradiol therapy on the coagulation profile of men with advanced prostate cancer....
CONCLUSIONS:
These results suggest that transdermal estradiol reduces thrombophilic activation in men with advanced prostate cancer, and protects against the risk of thrombosis.

Therapy Insight: parenteral estrogen treatment for prostate cancer—a new dawn for an old therapy
http://www.nature.com/nrclinonc/journal/v3/n10/pdf/ncponc0602.pdf

Transdermal Estradiol versus LH-RH Agonists for Androgen Deprivation Therapy: Benefits and Risks
Richard Wassersug, Ph.D
http://www.ppml-info.org/TDE.pdf

Phase II Study of Transdermal Estradiol in Androgen-Independent Prostate Carcinoma
http://onlinelibrary.wiley.com/store/10.1002/cncr.20857/asset/20857_ftp.pdf?v=1&t=hjspwa4m&s=aa1a3d2df88871187cbd66ea8c1abb32cc7bbc27
Follow-up correspondence:
http://onlinelibrary.wiley.com/store/10.1002/cncr.21528/asset/21528_ftp.pdf;jsessionid=E0F00C7F564B95C6114D3D15C7903ADD.d04t04?v=1&t=hjsptugz&s=de8a7901d12c13b099dbd6506d11ac39ab822ef1

Regards,
Earl

I had the 3-month Trelstar shot, both times, no pain or swelling at all. The side effects came on slowly, nothing drastic, almost imperceptible. I was also put on an estrogen patch twice a week, along with boniva taken monthly & vitamin D, the patch to reduce hot flashes(I had none), the other 2 to counteract the bone loss from ADT with Radiation.

Brain fog, forgetfulness, tender swollen breasts, loss of libido, muscle loss, less endurance, shriveled nut sack, not too bad though.

I also had shingles, radiation, followed by a green light laser, followed by seeds, so little hard to determine how ADT alone might be


The 2nd shot had a much more profound effect, I just felt terrible for two

Good reply Trepidation, the hard part is getting your doc to write a simple Rx for estrogen patches, but it does reduce or stop hot flashes and assists bone density and memory of which the LHRH drugs robs you of. Long term use of LHRH drugs like Lupey (lol) causes bone loss and yep some unfortunate guys have gotten fractures from such too.

Like Fairwind and others mentioned, it will come on little by little and not immediately as to the lovely side effects of which vary some, patient to patient. Hope they shake or warm up the stuff before your injection, if not it may feel like a nice bee sting when injected or have a painful injection spot. The main this is you can do this crap anyway. Your likely psa results might be maximum after about 3 months, which is what mine did but I also did ADT3 combo 2002-2004.

I hated the hot flashes and sweats and loss of muscle mass or power, forgetfulness is also common. I might have sugar coated it all (lol), you can handle it....I think.

I'll be getting my first Lupron shot next Tuesday, so this was very helpful. Thank you!

..It's been done. First shot..
A good day A bad day..... Whatever.....

I must like needles since I get one month shots. My doctor's original plan was to have me start with 1-month injections and transition to 3-month injections. But since I go into his office for a blood draw once a month anyway, I decided to stick with 1-month shots. Based on others here, my approach does not seem common.

Good luck Appleseed...may your hot flashes be few and manageable!

Down the rabbit hole!

From what I've been able to gather the side effects are mainly from having your testosterone wiped out, not from the Lupron itself. The various testosterone vs. time graphs from Abbot Labs look pretty similar. Once it's down at the target castrate (sigh....) levels, it just stays there no matter what dosing pattern you use. A larger question is what if it doesn't hold there near the end of the 6 month period? The literature says it stays down for the whole time, though. IDK...

The shorter time-period doses seem to allow ending the treatment period at some specific point. If you only need T held down for 3 more months, then take the 3 month shot, for instance.

Also, my insurance will NOT pay for the next injection until the absolutely full time period has elapsed. The doc's office said they'll deny coverage if you're even one day early. My next one is at 6 months, plus a couple of days since that made it on a Monday. It was billed at $500/mo, and $3000 for 6 months, so financially it didn't seem to matter. Astounding - $3000 for a thimbleful of white fluid! Bat wings and eye of newt must be pretty precious nowadays....

Others have said they like the one month version because they can see the doctor more often that way. That wouldn't really work for my doc's office; one of his assistants administers the injection. To see the doctor, one makes an appointment with him specifically.

It seems prudent to get a 1 month shot, after 4 weeks verify your T levels and PSA are dropping as expected, then go for the longer-term injection. Not everyone responds the same to these things, and there are other similar compounds for the same purpose.

On the off chance you're as geeky about this stuff as I am, here's a link to the one-month info sheet with more than you ever wanted to know about Lupron (graph on page 4):
http://www.rxabbvie.com/pdf/lupron7_5mg.pdf

And the 3-4-6 months info sheet (graphs start on page 26):
http://www.rxabbvie.com/pdf/lupron3_4_6month.pdf

Thanks grandpa, I see you are a G9 advanced. Also good to see you beat back that PSA to 0.06 this August. My PSA is 0.05 and it was 0.04 last month and that is before HT started. Now that I just started the HT I won't get a true PSA reading for a while. So 4-5 years we will see. Everyone fairs differently and you have those beautiful grand children to be around for, so if I was a bettin man I'd say you'll be around longer than that my PAc brother..

..get busy livin or get busy dyin, it's our choice.....
.........stay well Dave............Appleseed