Posted 12/6/2023 12:15 PM (GMT 0)
Eligard and Lupron stop the testes from producing testosterone. Prostate cancer needs testosterone to grow, multiply and move (become metastatic - stage 4 cancer). After a while the cancer becomes able to grow, multiply and move without testosterone. Some of the cancer cells have then become "hormone resistant".
Enzalutamide (Xtandi) locks onto testosterone receptors on the cancer cells replacing testosterone and stopping those cells from growing, multiplying or moving. Xtandi also locks onto testosterone receptors everywhere else in your body which has profound effects on them.
The leuprolide chemicals (Lupron, Eligard etc) stop some of the cancer cells from growing, multiplying and moving, the enzalutamide (Xtandi) stops the rest from doing that. That is why you don't hear about anyone getting just Xtandi as Xtandi is a drug that is given to treat the cancer AFTER it has advanced beyond being treatable with leuprolide chemicals.
It took me 18 months for the enzalutamide side effects to become unbearable so you may not notice those (feel different) for a while - if you get those side effects real bad. If you take a leuprolide chemical but your PSA doesn't become "undetectable" you will be given enzalutamide IN ADDITION to the leuprolide to bring your PSA back down to "undetectable".
Leuprolides are given first because the side effects are tolerable and they don't cost much. When those begin to fail you may be prescribed enzalutamide which has much worse side effects and costs lots more.
Hope that helps you.