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Posted 5/21/2020 4:38 PM (GMT 0)
I am about to begin Lupron soon and the doctor wants me to start taking casodex first. I have recurrent PC with very small lymph node Invasion, there was no enlargement on scan. I have no pain from PC. I would rather not take something that has no real benefit for me. Everthing I read says flare is trublesome for thoes with mets that are large and or painfull. Any thoughts out there?

2011 psa 6.2 treated cyberknife glesson
3-4
Psa drop in 4 years .068
Started slowly rising 4 years ago now 17
Posted 5/21/2020 4:54 PM (GMT 0)
I was told that casadex counters the flare. Taking casadex is no big deal. I just completed 3 weeks. Had Lupron shot. I will have radiation next week to zap cancerous lymph nodes. Hit it with everything!
Posted 5/21/2020 5:07 PM (GMT 0)

Hello Stecruz,

My PSA was skyrocketing at levels over 100, when I was being officially diagnosed.

By then, the cancer had already infiltrated both my lungs. Time was of the essence!

I was started out on LUPRON immediately.

In my case, Casodex WAS considered essential to start slaying a "fire breathing dragon" ... and avoiding further "flare" ...

I had no issues with Casodex ... and my doctor had specific reasons for prescribing it.

I feel, for your situation, that your doctor's advice will give you guidance.

Share your concern ... ask if CASODEX is essential ... and then get a plan going forward that's right for your case.

Doctors prescribe it based on clinical research showing that it throws water on "flare" ... a fire extinguisher, so to speak.

Best advice? Your doctor's ...

Keep us in the loop, Stecruz! We're all in this together!

Cyclone - # Iowa State University
Posted 5/21/2020 5:10 PM (GMT 0)
Casodex is also prescribed as part of combined androgen block aid. Many are on it for the duration of the Lupron. Being node positive, do what they say.
Posted 5/21/2020 7:14 PM (GMT 0)
I started Lupron + Casodex for my lymph node metastasis ( 10 pelvic and abdominal nodes) in November 2018. After one year, I am on ADT vacation from November 2019 stopping both Lupron and Casodex.
Posted 5/21/2020 8:53 PM (GMT 0)
I think flare is most pronounced if you have mets, but that it's still helpful in other cases. Additionally, Casodex in combination with Lupron can be more effective in some cases at lowering testosterone than Lupron alone. I started Casodex prior to Lupron and kept on it for my entire course of ADT. I had no issues and I'd be inclined to follow your MO's direction.
Posted 5/22/2020 1:08 PM (GMT 0)
I am currently on both. The only issue I had with Casodex was I got a rash 2 weeks after starting, so I took a few days off after I got my first Lupron shot. Now I have no issues with it. Lupron and radiation is a much bigger issue. I complete week three of radiation today.
Posted 5/22/2020 3:06 PM (GMT 0)
I was on Casodex for 3 months during SRT. You will likely be on it for only a month until the Lupron has time to kick in and are pretty unlikely to have any additional side effects other than much faster decline of your PSA.
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