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casodex monotherapy

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Prostate Cancer
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Posted 5/12/2016 7:55 PM (GMT 0)
Hi to all. My husband has been on casodex monotherapy for about a year. His psa in 2 mo. went down to .08 and has stayed there until this month when it jumped to 1.1. Of course we will be talking to our doctor about this soon, but has any one out there done this type of therapy? Our doctor asked us when we started if this therapy worked for 5 years, would we be ok with it, which unfortunately got it in our heads that it WOULD work for 5 years. Some questions: if your psa goes up like this can it go down, or is this a sign it has stopped working? Is the only next step to go back on Lupron? I would love to hear anyone's experience with this. When something works you get to mentally hop off the "I have cancer" car for awhile--looks like we have to hop back on. Thanks in advance for any responses and information.
Posted 5/12/2016 10:29 PM (GMT 0)
I'm sorry it happened so fast. The androgen receptor sometimes adapts to Casodex by actually feeding on it. If that's the case, withdrawing the Casodex might actually make his PSA go down.

Next steps depend on you. A new study, which I hated to see, demonstrated a small survival advantage to starting androgen deprivation earlier. (I'm hoping there are subgroups who don't benefit. In fact, Peter Carroll and Michael Leapmen from UCSF wrote an editorial questioning its universal applicability.) There's no easy answer - just a thing to discuss with his oncologist.

There aren't a lot of second-line drugs that he could get outside of a clinical trial without first demonstrating that he is both castrate-resistant (e.g., Lupron) and metastatic.

- Allen
Posted 5/12/2016 11:11 PM (GMT 0)
You might ask for a blood draw to check his testosterone level. The Casodex, by itself, can only do so much...So it looks like it's back to the Lupron..When that stops working, then your insurance will cover drugs like Xtandi and Zytiga..which work similar to Casodex but 10 times as well...With prostate cancer, seems like every 6 months there are new treatment options emerging and the brothers are living longer and longer..
Posted 5/13/2016 6:24 PM (GMT 0)
Hi Tahoe J,
I have been on Casodex monotherapy with 50 mg daily since December 2014, when my PSA hit 0.8
My PSA dropped to zero in 1-2 months and stayed there until December 2015 when my doctor asked me to stop taking Casodex, he wanted to see how the PSA and Testosterone will behave. My current PSA is 0.21 and he put me back on Casodex 50 mg but this time reduced the dosage to weekly. I feel fine and am grateful for the good quality of life.
Of course each patient is different and this therapy may not work for everyone
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