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Casodex & Lupron: Synchronization & Flare?

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Posted 6/18/2018 11:54 PM (GMT 0)

Balladeer said...
RobLee, Thank you so much for your comments, suggestions and sentiments...
On your initial Lupron injection, did you opt for the 30-day, 90-day or 180-day variety? And why?

Also, based upon your signature data, you appear to be one of the fairly limited group of folks who underwent RP surgery AND subsequent radiation, so another great question is this . . . do you have any regrets about having submitted to (or agreed to) the surgery?


It all comes down to what I know now versus what I knew then. My RO told me that he was putting me on hormone therapy. There were no questions and very little discussion. As I understand, the six month depot shot is a more recent development, and if a patient is started on a 30 day shot it is typically to see if there might be a reaction. All three of mine were six month injections. I was told everything from one to three years, and arriving on 18 months was the result of my own research here on HW and other resources.

As for the surgery, no, I have no regrets... well, only that it was not done sooner. If I had been diagnosed earlier things might have been different. I had persistent urinary problems and was given a lot of Cipro. My urologist only told me that my biopsy was negative. It was only when I changed doctors that I was given an MRI which identified my tumor. On the MRI it appeared to contained.

By that time, my wife and I had retired and we were in the process of moving to Florida. Our house had been put on the market, papers had been signed, winter was coming. RP seemed to be the most expedient means of addressing the problem. It was not until the post-op path report that my EPE and SVI were discovered. I did consult with two RO's prior to surgery, but while it is a "fairly limited group" that require salvage (or adjuvant) post-op radiation, there are a number of men whose pathology was upstaged upon surgical pathology.

The "trifecta" of RP, RT and HT is fairly common for the very high risk group of primarily G8's... even among those who went into surgery as G7's. One of the advantages of surgery is that not only is the entire gland removed and examined in the lab, but the surrounding tissues are as well, and staging is more exact... though I am sure there are some here who will refute the value of that given the increased incidence of side effects. Again, hindsight is 20/20, and at the time it was a relief to finally have a diagnosis and the hope that my case would be more straightforward than it turned out to be. One never knows.
Posted 6/19/2018 3:13 AM (GMT 0)
Back to your questions to me, 1 month or 3 month or 6 month Lupron Depot shot, I wasn't asked my preference. The MO just said he wanted to start me on Lupron with the 3 month shot, I said "sure". At that point, I just wanted to get the ADT started because it was 8 weeks since DX and both Dr King (SBRT at UCLA) and Dr Einck (25 treatment IMRT at UCSD) wanted ADT before radiation -- so I said lets do ADT while I make up my mind on IMRT or SBRT. And as to the difference in 1 month/3/6, it's a larger "depot" injected into you and regardless of the quantity it only breaks down and releases the same amount per day -- though logically to me that seems illogical smile

Back to IMRT vs SBRT, I decided IMRT because of the studies showing statistically significant probability of better outcomes (lower chance of reoccurrence) with IMRT + ADT + brachy boost. And the brachy boost seemed to be the key and could not find any SBRT protocols with a brachy boost of studies showing the similar outcomes for high risk as it relates to reoccurance.

As to my other fun, apparently my 2nd opinion from JHU is done (I saw the claim at my insurance website), but I haven't heard anything back from the UCSD UR whom I asked to send the slides. And the second fun was that my bone density test to get a baseline (not done until 3 weeks of Lupron thanks to a UC health system strike) showed I already have osteoporosis -- so another 6 month infusion for that. I've gone from zero prescriptions in January to now on three meds (Flowmax + Lupron + Zoledronic acid).

But I continue the good fight -- more stress trying to get a new house build going in CA than the PCa fight at this time.
Posted 6/19/2018 4:11 PM (GMT 0)
Re: Lupron reactions. I received a 6 month shot last Nov. 2017 and another one last month in May. Both times my butt hurt for about a week. More the first time than the 2nd. On day 2 after the first shot & day 3 after the 2nd shot I had a flu like reaction of feeling like I was body slammed. It lasted less than 24 hours. The day after I was a little off and then back to workouts after that. Of course we're all different so YMMV. (your mileage may vary)
Posted 6/19/2018 4:55 PM (GMT 0)

RobLee said...

Balladeer said...
RobLee, Thank you so much for your comments, suggestions and sentiments...
On your initial Lupron injection, did you opt for the 30-day, 90-day or 180-day variety? And why?

Also, based upon your signature data, you appear to be one of the fairly limited group of folks who underwent RP surgery AND subsequent radiation, so another great question is this . . . do you have any regrets about having submitted to (or agreed to) the surgery?

My RO told me that he was putting me on hormone therapy. There were no questions and very little discussion. As I understand, the six month depot shot is a more recent development, and if a patient is started on a 30 day shot it is typically to see if there might be a reaction.

As for the surgery, no, I have no regrets... well, only that it was not done sooner.

The "trifecta" of RP, RT and HT is fairly common for the very high risk group of primarily G8's... even among those who went into surgery as G7's.

RobLee,

Thanks so much for answering my questions and for taking the time to write such a detailed response. I truly appreciate it.

Needless to say (and I think you've also said this), we're all different, and we all seem to react differently to almost everything related to this miserable disease. If I've learned anything over this past couple of weeks, its that I'll probably end-up traveling my own road, with my own unique set of circumstances, and my own outcome(s), good or bad.

Given my own biopsy/PSA/Gleason numbers, surgery isn't likely to ever be available to me, and after researching it considerably over the past few weeks, I'm not really sure that I'd want it now, even if it was made available to me. Surgery vs. radiation, with or without ADT/HT, its all just one big mind-warping decision process. But one thing is for sure . . . since it appears that I'll have several months on Lupron before any proposed radiation treatments are likely to begin, I'm going to do my homework on it, tirelessly, and I don't just mean on techniques (i.e., IMRT/SBRT/LDR/HDR Brachy). I also mean on facilities, radiation oncologists, track records, etc.

There's no question that the superior expertise and instrumentation necessary for the best overall outcome are NOT going to be available to me here in my small rural town, and once you have to leave town to accomplish it, it doesn't much matter how far one has to go. In other words, if a guy has to travel 500 miles to a facility with a decent reputation for these things, and end-up staying there for 5-6 weeks (i.e., IMRT), then he might as well consider going 2,500 miles to the best of the best, whether its MD Anderson, Sloan-Kettering, Hopkins, Mayo or wherever! The way I see it, at that point, a guy might as well go "all-in". wink

Thanks again, and best of luck to you in your continued journey.
Posted 6/19/2018 5:12 PM (GMT 0)

CAdogsRus said...
. . . Back to IMRT vs SBRT, I decided IMRT because of the studies showing statistically significant probability of better outcomes (lower chance of reoccurrence) with IMRT + ADT + brachy boost. And the brachy boost seemed to be the key and could not find any SBRT protocols with a brachy boost of studies showing the similar outcomes for high risk as it relates to reoccurance.

CAdogs,

Yeah, my own experience with local medical oncologists and the planning phase of things has not been particularly great. While I've had my PSA and testosterone checked very recently, no bone density tests have yet to be conducted, and I'm already on Casodex, with Lupron soon to follow. Sounds like a bone density test of some form should have been done already, or certainly should be done soon. And as I said above, the issue of who admisters the Lupron and what duration of Lupron to get (30,60,90-day), strikes me as a reasonably critical one. If the administration/injection is a particularly 'dicey' procedure, and the nurse or phlebotmomist can't even hit a visbly apparent vein, then one tends to get a bit jittery about the level of skill and/or expertise for the entire facility and staff. What all of this tells me is that it would be prudent of me to perhaps slow down just a bit, on actually getting the Lupron shot, in favor of identifying the best possible form of Depot to have (30/60/90-day), and the best possible location to have it administered.
Posted 6/19/2018 5:15 PM (GMT 0)

GoBucks said...
Re: Lupron reactions. I received a 6 month shot last Nov. 2017 and another one last month in May. Both times my butt hurt for about a week. More the first time than the 2nd. On day 2 after the first shot & day 3 after the 2nd shot I had a flu like reaction of feeling like I was body slammed. It lasted less than 24 hours. The day after I was a little off and then back to workouts after that. Of course we're all different so YMMV. (your mileage may vary)

Thanks for sharing your experience, GoBucks! Every little bit of experience and advice helps. wink
Posted 6/19/2018 6:41 PM (GMT 0)

Balladeer said...
...
And as I said above, the issue of who admisters the Lupron and what duration of Lupron to get (30,60,90-day), strikes me as a reasonably critical one. If the administration/injection is a particularly 'dicey' procedure, and the nurse or phlebotmomist can't even hit a visbly apparent vein, then one tends to get a bit jittery about the level of skill and/or expertise for the entire facility and staff. What all of this tells me is that it would be prudent of me to perhaps slow down just a bit, on actually getting the Lupron shot, in favor of identifying the best possible form of Depot to have (30/60/90-day), and the best possible location to have it administered.


Yep, you need to be your own advocate here (as you are doing) and ask all the questions you need to get to a comfortable position for you.

I hadn't heard the administration of the shot was "dicey", however, I did read (after getting the shot) that the administrator needs to properly mix the drug with the "depot agent" it is bound with. If you search you will read that there's a quantity of drug that varies based on the duration (1,3,6) that is "mixed" with the "depot" and this is then injected. It then forms (more or less) a "mass" that will be broken down a given amount per day. I'm paraphrasing here and likely may be misstating this in terms of details, but the "big picture" in general should be correct.
Posted 6/19/2018 8:34 PM (GMT 0)

CAdogsRus said...

Balladeer said...
...
And as I said above, the issue of who admisters the Lupron and what duration of Lupron to get (30,60,90-day), strikes me as a reasonably critical one. If the administration/injection is a particularly 'dicey' procedure, and the nurse or phlebotmomist can't even hit a visbly apparent vein, then one tends to get a bit jittery about the level of skill and/or expertise for the entire facility and staff. What all of this tells me is that it would be prudent of me to perhaps slow down just a bit, on actually getting the Lupron shot, in favor of identifying the best possible form of Depot to have (30/60/90-day), and the best possible location to have it administered.


Yep, you need to be your own advocate here (as you are doing) and ask all the questions you need to get to a comfortable position for you.

I hadn't heard the administration of the shot was "dicey", however, I did read (after getting the shot) that the administrator needs to properly mix the drug with the "depot agent" it is bound with. If you search you will read that there's a quantity of drug that varies based on the duration (1,3,6) that is "mixed" with the "depot" and this is then injected. It then forms (more or less) a "mass" that will be broken down a given amount per day. I'm paraphrasing here and likely may be misstating this in terms of details, but the "big picture" in general should be correct.

Yup. I just read the manufacturer's published instructions for administration of Lupron-Depot (intended for medical professionals), and it fits with what you've said here. From the sound of it, its the initial 'mixing' and 'prep' of the solution that is most subject to screw-up, so I might be able to watch-out for that. Time alone will tell. However, its apparently injected intramuscularly (IM), rather than intravenously (IV), which is a definite blessing, given the recent mishaps I've had with one or two phlebotomists. eyes
Posted 6/19/2018 10:03 PM (GMT 0)

Balladeer said...
However, its apparently injected intramuscularly (IM), rather than intravenously (IV), which is a definite blessing, given the recent mishaps I've had with one or two phlebotomists. eyes

Yes it is IM. Mine is delivered by an RN who has done it for years in my URO office. No phleb would ever be doing that even in your rural area.
Posted 6/20/2018 12:59 AM (GMT 0)

GoBucks said...

Balladeer said...
However, its apparently injected intramuscularly (IM), rather than intravenously (IV), which is a definite blessing, given the recent mishaps I've had with one or two phlebotomists. eyes

Yes it is IM. Mine is delivered by an RN who has done it for years in my URO office. No phleb would ever be doing that even in your rural area.

Doh! Good to know. I had no idea that there was a difference in the people who poke you in the vein and those who poke you in the muscle. Goes to show, you learn something every day. wink
Posted 6/24/2018 5:13 PM (GMT 0)
Update: Just received some news on the effectiveness of recent Casodex treatment on my PSA results, and its initial rate of decline, so I thought I'd post it here for others interested in such things in the present or future:

PSA on 6/12/18 (1-day before beginning Casodex): 68.8
PSA on 6/24/18 (11-days into daily 50mg Casodex): 34.1

Hoping to get my first 6-month Lupron injection this coming week, and I don't know yet if the doc will want me to continue with the Casodex once the Lupron is on-board or not? I guess we'll see.
Posted 6/25/2018 2:50 AM (GMT 0)

Hello Balladeer ~

Wanted to welcome you aboard as a new crew member and comrade, here on the website.

You're getting a proactive plan in place --- you are asking questions --- you are educating yourself --- and best of all, perhaps --- you've started some TREATMENTS.

That's a great initial drop in PSA levels, isn't it?

Gosh, a little bit of good news likes that is all it takes to instill HOPE and ENCOURAGEMENT.

Sounds like you are going to add LUPRON to your arsenal of weapons in the battle --- I remember getting started right away on CASODEX and LUPRON.

I was diagnosed in my 40s, with a PSA over 100 --- and the prostate cancer had already infiltrated both of my lungs when I was diagnosed --- so my doctor got me started on CASODEX and LUPRON --- pronto!
No time to waste!

I can share a first-hand experience --- within just a few weeks, my PSA went right down to single digits --- that was a far cry from over 100, from DIAGNOSIS DAY, let me tell you.

From there, my PSA started creeping down into the decimal range. I remember my doctor saying, "You are having a tremendous response to the ADT shots." I could tell he was encouraged by my progress --- and SO WAS I --- believe me!

Along the way, I read an article about ADT shots (such as LUPRON, FIRMAGON, or ZOLADEX) --- and I remember the author of the article writing that these ADT shots begin to "starve and strangle" all the cancer cells that they can.

I will never forget those descriptive words --- that these shots begin to LITERALLY "starve and strangle" the cancer cells! In my case, based on those first PSA tests just a few weeks after my diagnosis, it was clearly evident there had been a lot of "starving and strangling" going on.

Since you are getting some treatments going, you might want to look up a thread put together by members here, that I think you will find helpful.

At the top of your screen, find the SEARCH BOX. Type in this thread title, as follows: LETTERS TO THE NEWLY DIAGNOSED. Click on that and the letters will all appear. Take your time, read a few, reflect ... and I think you will find encouragement in those letters, Balladeer.

I think you will see some tremendous results from your first LUPRON shot. I'm five years into this, and ADT shots are still helping me maintain my health goals.

On the day you get your first shot, just remember ... let the "starving and strangling" of those pesky cancer cells begin!

Sent with my best,
CYCLONE ~ Iowa State University
Posted 6/25/2018 6:21 PM (GMT 0)
Cyclone !!!!!!

You da man! Thank you so-so much for that great little backstory, and yes indeed, its absolutely "encouraging". As I've said elsewhere, I've encountered every sort of erroneous, misinformed, misguided and purposefully hurtful statement or report that one could imagine over this past year or so, and its rather tough to sift through at times. The fact is, like many-many others, I've carried a lot of loads over the course of my lifetime, much of them by my lonesome, and I've always managed to get through whatever it was, but I'll readily admit, this recent PCa diagnosis has been a heavy weight. Very heavy.

Anyway, thanks again for an enjoyable and entirely uplifting post, and thanks also for the "Letters to the Newly Diagnosed" reference. I'll check that out post-haste!

Cheers!
Posted 7/15/2018 11:25 PM (GMT 0)
Happy Sunday to all!

I'll try to keep this brief, but I thought I'd post a quick update on the side effects of 50mg daily Casodex and its continued impacts on my total PSA.

I've been on it now for just over 4-weeks, with my first Lupron injection scheduled for early this coming week, and I'm hoping (praying?) that the Lupron might be a little more forgiving?

The initial side effects of Casodex alone (days 1-20), weren't too bad, but by week three, the fatigue, light-headedness and loss of muscle strength have been front and center. In addition, for what its worth, I found the side effects of the 'Teva' brand, to be notably less severe than two other generic brands.

Anyway . . .

Total PSA just before starting Casodex (6/12): 68
Total PSA 11-Days after Casodex (6/24): 34
Total PSA today, at Day-32 (7/15): 12

Don't know if I'll continue with Casodex after the Lupron or not, but I'm certainly pleased with the rapid downward trajectory brought about by the Casodex.

Best wishes to all!
Posted 7/16/2018 1:14 AM (GMT 0)

Balladeer said...
...
Don't know if I'll continue with Casodex after the Lupron or not, but I'm certainly pleased with the rapid downward trajectory brought about by the Casodex.

Best wishes to all!

I was on both Lupron and Casodex for 3 years as part of my primary therapy. That's kind of unusual, mostly it's just Lupron for the long term.

If you've been on Casodex for a month, then start Lupron, I'd guess they'll keep you on Casodex for another 3-4 weeks. It takes that long for Lupron to actually take effect so the Casodex will keep the PSA down until it does. Whether to continue or not beyond that is a debate for sure, and you'll want to talk to your doctor(s) about it.
Posted 7/16/2018 4:25 PM (GMT 0)
Dang! I wouldn't have thought it would take a full month for the Lupron to become active. I was hoping to get off Casodex within 7-10 days, and I was also hoping to do the 30-day Lupron for my first injection (not the 90- or 180-day variety), just to see how I'll react to it. Oh well, it is what it is.
Posted 7/16/2018 7:23 PM (GMT 0)

Balladeer said...
Dang! I wouldn't have thought it would take a full month for the Lupron to become active. I was hoping to get off Casodex within 7-10 days, and I was also hoping to do the 30-day Lupron for my first injection (not the 90- or 180-day variety), just to see how I'll react to it. Oh well, it is what it is.


Here's a graph of the 6-month Lupron version showing it's affect on testosterone level.
VIEW IMAGE
I think the 3-month & 1-month versions probably work in a similar manner.
Posted 7/16/2018 7:43 PM (GMT 0)

Kent M. said...

Balladeer said...
Dang! I wouldn't have thought it would take a full month for the Lupron to become active. I was hoping to get off Casodex within 7-10 days, and I was also hoping to do the 30-day Lupron for my first injection (not the 90- or 180-day variety), just to see how I'll react to it. Oh well, it is what it is.


Here's a graph of the 6-month Lupron version showing it's affect on testosterone level.
VIEW IMAGE
I think the 3-month & 1-month versions probably work in a similar manner.

Thanks Kent! That's helpful, and it makes it pretty clear (i.e., 4-weeks).
Posted 7/16/2018 8:11 PM (GMT 0)
I remember the T level at my first PSA test on Lupron was 30, though I don't remember how far in that was. Then after a year it was 19, then at 18 months it's now 9. So I guess it becomes asymptotic... rapid initial decline and thereafter always approaching but never actually reaching zero.

Now to see just how long it will take to get back up again, if it still has any legs to stand on.
Posted 7/18/2018 6:16 PM (GMT 0)
O.K., so, I received (or at least I 'think' I received?) my first 90-day Lupron injection yesterday? I say I "think" because my local hospital that adminsitered it, is the same misfit group that struggled twice in hitting a vein for a PSA/T draw a couple of weeks ago, and the same outfit that lost the tube of blood intended for send-out analysis of Testosterone drawn that very same day.

The circumstances are made even muddier by the fact that the local 'Keystone' Lupron/Infusion crew that prepped and administered the shot, had dropped a tray of related supplies in the middle of the tile floor while I was sitting there waiting, and then, the injection itself was done in the upper buttocks, not in the arm where I would have been able to see things more clearly.

What a nightmare! Color me a skeptic, but when you have incompetence like that on visual display, it can't help but make you question the integrity of the entire medical community and 'treatment' processes in this country. To be clear, I'm exceedingly happy with the treatment and care that I've been receiving (and will continue to receive) out-of-state, but that group is head-and-shoulders above my local hospital in every metric you can imagine, so there is no doubt that the quality of medical care in certain areas of this country (particularly rural areas like mine), is really eroding.

And of course, once a guy starts questioning people and processes, its essentially a slippery slope from there. The mind starts to wander about whether they've screwed-up something else, like criss-crossing blood samples, or mixing the wrong Lupron product (i.e., 30-day vs. 90-day version), etc. Hell, at the purported cost of $6,700 per shot of Lupron, one starts to wonder whether they've even adminsitered the drug at all! Maybe the syringe contained nothing but saline? I dunno? That'd be a tidy little savings for their budget.

Oh well, it is what it is! Maybe they did mix it and administer it properly? Who's to say? Maybe its just the combined effects of Casodex and Lupron that has me hallucinating and seeing demons everywhere? I think I just need a couple of beers! rolleyes

Cheers!

FYI - Here's a chart that illustrates the effects of the 90-day Lupron injection on Testosterone over time. Assuming they don't lose this second tube of blood intended for Testosterone analysis from yesterday, I should be able to tell whether the Lupron shot was administered properly, and whether or not it was effective within 2-3 weeks. Safe to say, I won't have the same hospital do that next round of blood draw or testing. Sheesh! wink

www.lupronprostatecancer.com/Content/images/hcp/efficacy_3month.jpg
Posted 7/18/2018 6:43 PM (GMT 0)
Hey Balladeer - that sounds crazy!

My shots were in the upper buttock too. Sometimes I couldn't feel the needle, sometimes it was rather uncomfy. You should know within 24 hours if it went in there, since it will feel a bit tender at that site. Rather like a deep bruise, but it clears up in another day or so. Also, you should see your PSA continue to drop. Will you continue on Casodex? Generally, people don't.

My PA opened the package in my presence, showed me the label for what the shot was, mixed it while I watched, and then injected it. I never had any doubt what she was injecting.

That chart is really familiar. I printed it out, and noted every couple of days what my T should be based on that prediction; even my starting value was right where that graph begins. Never had T tested, but right on schedule when the chart predicts a 50 ng/dL level (defines castration T level), I had my first hot flashes (between 3 and 4 weeks in). Within another week, those were happening like clockwork every 1.5 - 2 hours day and night. That went on for pretty much the whole time I was on Lupron, three long years. I decided to accept them as ongoing proof that the Lupron was suppressing my testosterone as intended!

Good luck.
Posted 7/18/2018 7:01 PM (GMT 0)
Thanks Redwing!

Yeah, this is one of those rare times when I'm actually 'wishing' for obvious side effects, in hopes that it will confirm the presence of Lupron. Like you, the actual injection (the needle stick) was fully detectable, but I had no way of knowing what (if anything) was actually injected. No added side effects at all on Day-1, but I'll definitely be watching for them over this next 7-10 days, and of course, the real proof will be when we look at the T level at weeks 3-4 weeks. It was a long time ago, but the last time I had my T-level checked was in early 2016. It was 239 ng/dL back then, and if I'm understanding things correctly, it should spike here briefly this first week, then, if all goes well, hit the target 50 ng/dL mark (or less) by week 4. If it doesn't, then I'll know something might have been amiss. Until then, I'm just going to assume that I'm a cynical idiot and imagining things, which could easily be the case.

As for Casodex, yes, I've been instructed to stay on it for just 7-10 more days, but its been so successful at depressing the PSA to this point (69 to below 12), that I'm inclined to stay on it and just endure the added side effects. If I do so however, my concern would be whether it might somehow mask the absence of Lupron or its effects. To that extent, its the future levels of Testosterone (not PSA), that will be the key indicator of Lupron's presence or absence. Needless to say, its essential that the Lupron be on-board and doing its magic for a full 8-weeks prior to LDR-BBT, which is scheduled for late September. Its a shame really, because there shouldn't be this kind of uncertainty. The wife tells me . . . "relax", I'm sure they did the right thing", but me being the worrywort that I am, all I can do is hope there won't be any problems.
Posted 7/19/2018 7:28 PM (GMT 0)
UPDATE: I want to try and keep this thread as complete and thorough as possible for others who might view it in the future, so I'm going to add another small piece of information that just came to light this morning, regarding Casodex and its overall effects/effectiveness with respect to PSA and T.

Earlier this week, after almost 5-weeks of continuous 50mg daily Casodex treatments, I had my first Lupron injection, and prior to the injection, the doc ordered a blood test for baseline (pre-Lupron) testosterone level. Significantly, it went from a pre-Casodex/pre-Lupron/Pre-Dx level (taken back in early 2016) of 239 ng/dL, to 534 ng/dL. Note: Normal reference range is approximately 264-916 (mean: 539).

Presumably, this marked elevation in T level is a direct/indirect result of the inhibited binding of testosterone brought-about by the Casodex, and presumably (hopefully?), this same number (534 ng/dL), will drop rapidly over the next 3-4 weeks from the recent addition of Lupron, which should reverse this trend and reduce circulating levels of testosterone by inhibiting its actual biosynthesis.
Posted 7/20/2018 2:01 AM (GMT 0)

Balladeer said...
....presumably (hopefully?), this same number (534 ng/dL), will drop rapidly over the next 3-4 weeks from the recent addition of Lupron.

It's going to drop like a rock. In case no one mentioned it, you may get the "Lupron Flu". I've had 2 shots. First one hit me on day 3. Second one on day 4. Fatigue that sent me to bed. Done in 24 hours with another 24 hour light hangover. And my butt was sore for a week. The 2nd shot goes on the other side to keep things even. Hope you get a light reaction.
Posted 7/20/2018 3:43 AM (GMT 0)
Man, I sure hope so! But I gotta admit, I remain a tad skeptical at this early stage. Its only Day-2 at this point, but no soreness at the injection site (none whatsoever), no noticeable bump or obvious medication presence at the site, and no side effects other than the usual ones associated with the Casodex. However, it could easily be too early yet, as others have indicated that it often took weeks (not days) for them to feel the true brunt of any effects. I guess time alone will tell.

Many thanks!
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