lupron and emphysema

Has anyone else developed emphysema after taking lupron? It is a rare but severe side effect. My husband has, and we are interested in whether or not it has happened to others with prostate cancer.

This is certainly a case where the expertise of your oncologist, and perhaps also a pulmonologist, is needed.

If it is determined that your husband is having an adverse reaction to LUPRON, please know that there are other forms of ADT shots.

After LUPRON wasn't sufficiently reducing my testosterone levels consistently each month, my oncologist felt we could find a more effective ADT shot for me. I next tried FIRMAGON, but it didn't have the desired effect, and I had major site injection reactions to it.

As they say, the third try is the charm - I then tried ZOLADEX injections, which worked best for my particular case.

Ironic situation: my original urologist REFUSED to try anything but LUPRON, because he refused to try newer forms of ADT shots. That's the day I removed him from the starting lineup on my medical team, and he became a benchwarmer.

That very day, I asked to see my oncologist, who IMMEDIATELY suggested new alternatives to LUPRON ---- other forms of FDA approved ADT shots.

I'm forever grateful to him for helping me find something that worked better than LUPRON, for my particular case.

I will also say --- we waited until the LUPRON shot "expired" first --- but it was VERY easy to switch over to the other forms of ADT shots.

My lesson learned? Consult with your doctors, and become your own advocate.

If your doctors determine LUPRON is causing emphysema, you certainly have other options ---- namely FIRMAGON and ZOLADEX shots.

Let us know how you're faring ----
Cyclone --- Iowa State University

Of course there is no absolute way to know that the lupron caused the emphysema. John was a smoker for 30 years before quitting about 20 years ago. He has never had any lung problems previously, and this came on very suddenly after he had been on and off lupron for a few times. He still has none of the usual symptoms of emphysema (no coughing at all, no chest pain) except for shortness of breath. He went from being an active man who walked two to ten miles a day to one who can only walk short distances with very little exertion. That's why we think it's the lupron. The literature on lupron says it can cause severe emphysema in rare cases.

We are scheduled to see the medical oncologist next week, and we will ask about other adt medicines. His psa has begun to creep up again. One thing I'm most concerned about is "will the emphysema go away if the lupron is dc'd?"

I'm also interested in knowing how long you have been on Zoladex and how long it has kept your psa down?

Thanks so much for all the replies.

Thanks for your replies.

Eligard is another alternative.

A long history of smoking would clearly be the cause. Not a few months of Lupron.

If you need ADT to control the PCa then use any number of effective drugs. It is of no use to assign a side effect to a drug that you are using to control the PCa. There are many alternatives to Lupron that achieve the same result.

What does your oncologist say?

So if you know he has developed emphysema, what does the pulmonary specialist say? Hopefully he has also been regularly screened for lung cancer. When he is on a drug like Lupron all his other doctors should be informed.

I have searched for the reported incidence of Lupron causing emphysema and could only find the label information stating it is a very rare side effect. That basically means one in a million the way the drug labels have to list observed or suspected side effects. You have to go back to the clinical trial data to see what was reported that was required to be listed as a rare side effect. Lupron is also commonly used for women. The side effects list doesn’t state whether men or women have reported any link between Lupron and emphysema.

If your husband had never been a smoker, never been around second hand smoke, never had asthma or other lung conditions and then developed emphysema while or after taking Lupron, then it might be the culprit. But trying to tie it to the Lupron when he smoked for 30 years appears misguided to me. Most people that smoke that long do develop adverse lung conditions including emphysema. Of course consult with the oncologist and pulmonary specialist and get the emphysema treated. As has been stated, there are other drugs that can be used as alternatives to Lupron. All have their side effects listed and you should check into them.

Regarding drug label and advertising information the USA and New Zealand are the most stringent in the world. Most all other countries basically describe the drug and its intended uses and list only the most common and expected side effects. Many countries don’t even do that much.

Why is the labeling and advertisement protocol so tough in the USA? Two reasons, the FDA and litigation.

Basically the FDA requires all reported reactions and side effects of the drug during the qualifying clinical trials to be disclosed, even in the absence of causative proof. These are then compiled into the Common, Uncommon and Rare categories on the label. The FDA then continues to compile information from researchers, patients, doctors and hospitals and can direct the drug company to update the label. The FDA website encourages patients to report reactions and side effects. When doctors and hospitals learn of adverse reactions not listed on the label, most are diligent in reporting such information. Pharma companies have armies of sales reps that are also fishing for information on adverse reactions when they interface with medical providers.

The USA is the most litigious society in the world and every manufacturer must practice defensive management and communication. When a person takes a drug by the label and then experiences an adverse reaction, they can’t normally hold the manufacturer responsible when the manufacturer included the possibility of such a reaction on the label. If the manufacturer had any idea such a reaction was possible and did not include the warning, then the case would be a slam dunk for the patient and be costly for the manufacturer. Such a situation could even present an existential threat to the company. Pharma companies have legions of lawyers making sure the company can prevent law suits by the information and warnings they communicate to the providers and consumers.

So regarding the label warning under Rare that emphysema may be a side effect of Lupron, it could be that somewhere sometime in the clinical trials or subsequently someone reported they developed emphysema during or after the use of Lupron and had no other risk factors of developing emphysema. Based on the report the manufacturer would probably list it on the label and the FDA would likely require the listing.

Harp-Lady, I suggest you ask the oncologist how often patients on Lupron developed emphysema due to the Lupron. I also suggest you ask the pulmonary specialist how many Lupron patients they have treated for Lupron induced emphysema. Answers to those questions will tell you a lot. Both these doctors would be aware of your husband’s smoking history and risk to lung conditions and disease, particularly emphysema. That neither told you no to Lupron would indicate that in their knowledge and experience they have decided that Lupron is not a causative risk to developing emphysema.

And regarding label side effects, just look at aspirin. If every one read the label, the most common drug would probably never be taken.