Casodex Before Lupron ADT

I have noticed several postings where Casodex was used a few weeks prior to Lupron.
Does this strategy lower the Testosterone spike that typically happens if both Casodex and Lupron are started at the same time ?

Yes, in my case Casodex was for one month and the first Lupron shot was about a week after I started Casodex. I believe that this is pretty typical.

Post Edited (Sr Sailor) : 4/10/2019 6:05:52 PM (GMT-6)

Depends on your risk level and knowledge of Mets, particularly spinal. The first shot of Lupron will usually cause a testosterone flare. This flare can cause Mets to enlarge before reducing as the Lupron effect takes over. If there are spinal Mets that are significant this can cause a spinal compression. Of course that is another reason docs should order a bone scan before treating high risk cases. The early round of casodex will prevent the flare. Rarely is the flare a problem but many doctors use the casodex just in case.

my uro opted for no casodex because of my history of hep c. however we later discovered that somewhere along the line I had cleared the virus.

That testosterone flare is an interesting question. If you subscribe to the "saturation theory" for testosterone's (T) effects on prostate cancer, then once the T level is above some minimum, whatever that may be, then more T doesn't matter. The analogy has been like floating a boat, once its afloat it doesn't matter how much deeper the water gets. So, when people consider supplementing their T after hormone therapy, thinking that if it's already greater than 50, or 100 or so, then more won't matter. Get it up to a level that "feels good", because it won't matter to the prostate cancer.

But, if that's the case, then why does more T cause existing mets to suddenly become a problem when starting HT? Why is Casodex to prevent the Lupron flare necessary at all? Unless the T level really does matter?

Just a curiosity.