Question for the HT brethren...

I don't know if it's much help but I had three 3-moth Lupron shots and didn't have hot flashes till after the last shot, which was around the six-month mark.

ed

 

Redwing,
In theory, if you are getting your injections on schedule, your T level should remain castrate and somewhat constant, with some slight variation, with each subsequent injection. My hot flashes are highly correlated with ambient temperature and the season of the year. I suppose it is also possible you are just now getting to meat of the SEs and your intensified SEs are just a matter of timing, unrelated to the actual injection. It took me a few months to really start feeling the intense effects.
SC

Hi RW,
Megace (megestrol acetate) is a steroidal antiandrogen as compared to Casodex which is a non-steroidal antiandrogen.
Megace has been used to reduce hot flushes caused by androgen deprivation. The medical literature has reported that Megace has driven PCa progression. See a case of one at:

www.ncbi.nlm.nih.gov/pubmed/10219363

The potential mechanism involved is related to the hormonal receptors present. Megace is a progestin and as such it can be metabolized by the individual patient to androgens and estrogen. Many of the hormonal receptors present, can be activated by the synthetic progesterone and its metabolites to cause progression or inhibition of cell growth.

Other progestins such as Depo Provera have been used to reduce hot flushes with success. See:

www.ncbi.nlm.nih.gov/pubmed/12551811

Some doctors recommend a small estradiol(E2) patch to reduce the intensity of hot flushes induced by androgen deprivation.

Because of the complex mixture of hormonal receptors in the prostate gland and depending on how intense or frequent the hot flushes persist it is prudent in patients who demonstrate resistance to androgen deprivation to avoid a remedy. Those responding well and in good vascular health can try a small estradiol patch rather than synthetic progestins because of better QOL.

It is difficult to recommend a remedy because we all can react differently to each of those. I have talked to patients who reacted favorably in reduced hot flushes by taking soy protein and others that reported that Gabapentin did the trick.

Wish you for a quick resolution of your present situation,

RalphV

Hi Redwing,

FWIW, my hot flashes are all over the place. I have days when I get them every 30 minutes and other days when I only have a handful. I get a 1-month Lupron shot but I notice no correlation with the timing of the shot.

The only correlation I do notice is the ambient temperature. If I'm someplace cool, like an outside evening sporting event I will NEVER get a hot flash. But when I switch from cold to hot then I get one right away. In general, I try to stay a bit cooler than I'd like which does seem to lessen the hot flashes.

I do take gabapentin at night to help with the hot flashes. At first it felt like a wonder drug since it stopped the hot flashes in their tracks. But now it just seems like they're lessened a bit, which is still helpful since it helps me sleep better.

Michael

Hi Redwing:

Just curious: who do you see for your PC? Is it a doctor at Umich?

Anyway, when I read up on HT comments prior to my starting it, many indicated that at the end of their shot time period (usually 3-4 months) the SE seemed to lessen slightly and then they increased significantly soon after the next shot. This was very noticeable around their third shot. I am finding the same thing. My hot flashes have worsened somewhat, although since yesterday they are started to lessen in frequency. I get a lot of them during the day (and at night). I just shrug them off. I agree with the previous comment regarding Megace. I would recommend doing nothing but if they get bad, I know Dr. Meyers and others recommend a small estrogen patch (0.025 or something like that) as mentioned in earlier responses.

Hang in there, buddy!

Mel

Redwing,

Tonight I get my 13th 1/4ly Zoladex jab, I don't believe my hot flushes are related in anyway to the timing of the injection. I get 4-5 a day of various intensities.

Mine are mostly related to temperature and humidity, how relaxed I am and if I have been rushing or hurrying. I find at work with my air conditioning set to under 20c I have a reduced number. I have even found in summer I can get out of a near cold shower, dry off and start to get dressed to go out and I am in a lather of perspiration, my shirt is totally wet, I end up having another shower and start again.

I have just gone cold turkey and not worried about looking at other medication for the hot flushes because I already need to own shares in a pharmacy because of the tablets I take.

Best of luck

My hot flashes are most noticeable at bed time; however, a dip in a cold swimming pool (or a cold shower) seems to alleviate them and provide a better night's sleep.

Ok, drawing courage from Tall Allen's post, and being endlessly curious (main reason I'm an engineer), I decided to give the Megace another chance after being off of it a few days now.

So, this morning I started again with the twice a day 20mg regimen.

I still don't know how fast this stuff should have an effect, but so far today the hot flashes have been quite similar to yesterday before Megace (about 1-1/2 hours apart, intensity about the same).  That's way better than last week when my system freaked out.  Not any worse, and we'll just have to see over the next few days if it's any better.

It's amazing we all tend to respond so differently to these things.

red:

tHANKS for the info.

So far, I'm resisting adding another drug to the mix.

My hot flashes are a pain, but tolerable.

I did notice they increase for 3-4 weeks after my shot (4-month shot).

Mel

Red,
You have many people in your corner to include our gurus RalphV, Tall Allen, and many others. We all wish you the best! My 3 year journey with lupron ended with a 6-month shot in April and in Oct my Dr said we'll see. It's probably strictly against medical protocol but my hot flashes were at night and coupled with my numerous trips to the bathroom there were days when I was "completely wiped out". On rare occasions I took a 5mg tab of Valium and that would knock me out for the night so I could face the next day--just a thought and certainly no medical recommendation; see what your Dr thinks. Wish you all the best,!
Bill

Thanks for the positive comments, all! Moral support is really helpful.

Peter, I know a woman taking fluoxetine, and she found early on it helped her with her hot flashes. Her doctor said it sort of tweaked the brain chemistry that was getting whacked by the loss of her normal hormones. You might be onto something there.

Redwing,

My primary med onc (Myers) made estrogen patches (.1) part of my treatment package as soon as I commenced HT. He suggested that they would serve as a bone shield AND minimize hot flashes. That was two years ago and to date hot flashes are rare and cause no real discomfort. Everyone's circuits are wired differently but I'm sure you have discerned by now the onus is on then patient in treatment selection for this disease. You may want to discuss this option with your guy.

Jim