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Posted 12/9/2016 5:44 PM (GMT 0)
Greetings - I couldn't find an answer anywhere. I'm just ending my 2nd year on Lupron. Only side effect has been an occasional hot flash. My PSA has spiked, so we (me and my urologist/surgeon) started Casodex 5 days ago. My questions are - If had no side effects to speak of with Lupron, would that hold true for Casodex, or since it's a different med, that would not hold true? Or, with 2 medications now, would I probably have more side effects due to the power? Lastly, how long before side effects start to show up with Casodex? Off subject - We just did a bone scan and it still has not spread. I started out with a PSA of 570 (yes - that's hundreds). After 9 months of Lupron, it was down to 20. PSA stayed there for 6 months, but then spiked to 28 for two successive readings, so that's when he ordered Casodex. He's never seen numbers like this. He's saying 20 was our low point, so it's time to act. Interesting, huh?

Post Edited (Len) : 12/9/2016 12:01:30 PM (GMT-7)

Posted 12/9/2016 10:25 PM (GMT 0)
Len...VERY interesting ......don`t have much to add...I`m off my 6 month Lupron as of now ....just wanted to WELCOME you to the forum....I`m sure some guys will chime in about your questions.....Good Luck ! David
Posted 12/9/2016 10:47 PM (GMT 0)
It's time to make an appointment with a Medical Oncologist..Most Urologists are out of their element when treating advanced prostate cancer...Maybe talk to your primary care physician and get a referral to see an MO from him...

The bicalutamide (Casodex) will have few side-effects of it's own..It works differently than Lupron does..Hopefully, you will get a good response from it..The drugs themselves have few side-effects..It's the fact that your testosterone level has been reduced to a very low level, THAT's what causes the side-effects..You should have your testosterone level checked along with your PSA to be sure the Lupron is working as hoped..
Posted 12/10/2016 1:24 AM (GMT 0)
Casodex has its own side effect profile, particularly gynecomastia (breast growth and tenderness). To avert that, your doctor can prescribe 10 mg of tamoxifen daily. Lupron and Casodex do very different things. Lupron prevents the testes from secreting testosterone, while Casodex blocks testosterone from activating the androgen receptor (which would encourage the cancer to replicate).

Sometimes Casodex works for awhile, sometimes it doesn't. If not, your doctor can prescribe second line hormonal agents like Zytiga or Xtandi. They work in a different way and are always taken together with Lupron.
Posted 12/10/2016 4:21 PM (GMT 0)
Thanks to all above and whomever else may chime in ...
Posted 12/11/2016 5:09 AM (GMT 0)


Hello Len,

I had an initial PSA reading of over 100 when I was first diagnosed, with some complexities, because the prostate cancer had already infiltrated both of my lungs.

I've pursued treatments ever since --- as shown by my treatment signature below. You might want to create a detailed treatment signature in your profile, so that others can continue to share insight and advice with you on your particular case.

As others have shared above, adding an oncologist who specializes in advanced prostate cancer, is an important step.

My initial medical team was comprised of my urologist --- soon thereafter, I added a medical oncologist. That step alone opened up many new avenues and possibilities for treatments.

We all deserve the best medical care --- all of my doctors work together as a TEAM in my behalf --- consulting together, sharing test results, sharing scan results --- all of those things.

Stay proactive --- ask questions --- get a second opinion, if needed --- and be sure to have an oncologist who is an advocate for your case.

Stay in touch with us here --- let us know how you're faring --- stop in often for a visit --- we'll leave the front porch light on for you !

Sent with my best,
"Cyclone Team Fan" ~ Iowa State University
Posted 12/11/2016 6:25 AM (GMT 0)
For me, I was put on both Firmagon,which is similar to Lupron and Casodex after dx two years ago and in 30 days after the first treatment my psa went from 209 to 1.2. Two months later while still on Firmagon and Casodex it was undetectable <0.02. At that point the doc took me off Casodex and told me to "save it for a rainy" day. The next month April 2015 my psa jumped to 0.10 while off Casodex. The doc was worried but told me to stay off Casodex one more month to see if the upward trend continued. It did in fact. On May 2015 it had jumped to 0.15. The doc immediately put me back on Casodex as well as the ongoing monthly bullet to the gut of Firmagon and I have been undetectable <0.02 ever since.
The side effects that I believe that the Casodex gives me is slightly enlarged breasts and mild nausea on some days that resolve quickly.
Heck, if the Casodex is successful for you as it has been for me so far, it will buy you at least another year + of hormone sensitive PC so GO FOR IT

Good luck
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