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Thread: Alternatives to Lupron

  1. #1
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    Alternatives to Lupron

    Is there anything better than lupron?
    Age 54
    DRE Lump on right side
    PSA 10.8 12/16/2011
    Diagnosed 12/23/2011
    Gleeson 4+5=9
    Prostate out 1/30/2012 - Robotic Laproscopy (LRRP) both nerves spared
    Perineural invasion, seminal vescile invasion, positive margins
    1 of 8 lymph nodes positive, 3mm
    Post LRRP PSA (6 weeks out) was .1
    Post LRRP PSA (12 weeks out) was zero before 1st Lupron shot.
    Been on Lupron since May 1 or 2012.
    My wife free of breast cancer for 15+ years

  2. #2
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    Before the drugs like Lupron were discovered, orchiectomy, surgical castration, was the standard treatment..For men likely to need hormone treatment for the duration, it's still a viable option. It lowers testosterone to the lowest level possible and it works very quickly. Typical cost is less than half of one Lupron shot so for men without medical insurance, it offers effective, low cost treatment...There are other drugs more expensive than Lupron that claim to work better but insurance companies will seldom approve them...

    If drugs like Lupron are to be used, the "T" level needs to be monitored closely to make sure the drug is working well enough to be effective. Some oncologists will prescribe 3 different drugs, "The Triple Blockade", to get the maximum cancer fighting effect.
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5.

  3. #3
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    Some have said that newer more expensive medicine Firmagon is better in terms of side effects.

    http://en.wikipedia.org/wiki/Degarelix

  4. #4
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    Usually, when you are on HT, the effects of testosterone depletion far overshadow any side-effects caused by the drugs themselves...The fact that your PSA dropped to undetectable at 12 weeks is a very good sign. Your doctors may take a wait and see approach before moving on to RT & HT......
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5.

  5. #5
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    Quote Originally Posted by Fairwind View Post
    Usually, when you are on HT, the effects of testosterone depletion far overshadow any side-effects caused by the drugs themselves...The fact that your PSA dropped to undetectable at 12 weeks is a very good sign. Your doctors may take a wait and see approach before moving on to RT & HT......
    Zero at 12 weeks (before ADT) was indeed good news when you got a path report like mine. However, according to the Han tables and other predictors its not likely to stay at zero without treatment.

    The radiation onco wants to do 37 treatments (7 to the prostate fossa) and the regular onco wants to keep me on Lurpon for 2 years. I am, obviously, very concerned about the permanent side effects of this course of treatment. Early intervention with Lupron is a no brainer. Not sure if I should wait until something shows up on a scan before doing radiation. The radiation onco does not want to wait for that. But I want to give myself more time to heal up and everything down there IS healing, slowly but surely --so far. What would you do?
    Age 54
    DRE Lump on right side
    PSA 10.8 12/16/2011
    Diagnosed 12/23/2011
    Gleeson 4+5=9
    Prostate out 1/30/2012 - Robotic Laproscopy (LRRP) both nerves spared
    Perineural invasion, seminal vescile invasion, positive margins
    1 of 8 lymph nodes positive, 3mm
    Post LRRP PSA (6 weeks out) was .1
    Post LRRP PSA (12 weeks out) was zero before 1st Lupron shot.
    Been on Lupron since May 1 or 2012.
    My wife free of breast cancer for 15+ years

  6. #6
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    First, you want to be completely continent (if possible) before you start any radiation treatment. Radiation will freeze your recovery from the surgery right where it is..At this point in your treatment, the HT is used to increase the effectiveness of the radiation..Recent studies have shown radiation is twice as effective when HT is in place during and after the radiation treatment. While HT by itself might have some post-surgical benefit, that has not been demonstrated..

    With the positive node and Gleason 9, doing adjunct radiation and hormone treatment is pretty much the standard treatment. I too am a G-9 and have undergone all three treatments..My post surgery PSA never dropped below 0.9 but it has been undetectable since the end of my RT...My radiation oncologist at first wanted me on HT for 2 years but relented and stopped the Eligard (Lupron clone) after 14 months on the strength of my undetectable PSA and my complaints about the side-effects..The latest studies show that 12 months of HT is almost as effective as 24 or 36 when used as a adjunct to radiation..Many doctors will still press for 24 or even 36 months which can bring on some pretty heavy side-effects and make recovery from HT slow and difficult, if you recover at all..

    Before you jump on the treatment table under a LINAC, try and find the most up to date machine you can..Many treatment centers are still using 10 and 15 year old equipment which is at a disadvantage when compared to the newest machines which can be aimed more accurately and deliver a higher dose while doing less damage to surrounding healthy tissue...Ask your R.O. this question: "Do you have access to a Varian RapidArc ?" and see what he has to say....Like surgeons, all R.O.'s are not the same..Find the best one you can, one that has treated hundreds of prostate patients..They will write the computer program that controls the LINAC during your treatment... I had 40 "fractions" 72 Gray, full pelvic, and like you, the last 7 were called "Boost" and tightly aimed at the prostate bed. Best of luck to you....

  7. #7
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    Can you tell me where to look for the studies you mentioned?
    Age 55
    PSA 32
    Biopsy 12/12 positive
    Gleason 4+5=9
    Bone scan and MRI clear

  8. #8
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    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5.

 
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