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Lupron & Casodex Not Working

pcinpa
Posts: 5
Joined: May 2010

Found out that the Lupron & Casodex therapy not working. The Lupron only worked for 2 months. Started chemo with Taxotere this past Friday. Does anyone have any info for this treatment.
Sincerely appreciate any experiences or info available.

Trew
Posts: 892
Joined: Jan 2010

How long have you been in treatment?

I started a thread long ago about a man in the dental chair of my daughter-in-law in CA who had PC. Instead of the long protracted hormone treatment he found a doctor that started chemo much earlier than most doctors ever start patients on chemo and it worked for him. My daughter-in-law was trying to locate the name of the pattient but he was moving out of the area and I have not heard back from her. But it is my desire to start chemo, it it comes to that, as early as possible in the course of this disease.

I hope the chemo works for you. May the God of peace be with you.

I don't know if you ever saw the old Moby Dick movie with Gregory Peck (One of my favorite all time movies) when cap't Ahab raises a drink and has all the men drink to the "death of Moby Dick." Of course, it didn't quite turn out that way in the end, but tonight, I raise a glass (and a prayer) "Death to PC!"

Like Cap't Ahab said, "this thing vexes my soul."

pcinpa
Posts: 5
Joined: May 2010

I greatly appreciate your input. I was diagnosed in January 2010 with a Gleason of 9 with 2 cores greater than 80% and it had already spread throughout my body. Lit up the nuclear scan like a Christmas tree. Immediately started with the lupron & casodex. Lasted only 2 months. Currently treating at the University of Pennslyvania. Inprocess of making arrangements to go to Sloan - Kettering in New York for a second opinion. Remaining hopeful tht the chemo will be sucessful. Thank you for your blessing.

mrspjd
Posts: 693
Joined: Apr 2010

pcinpa,
I'm sorry that the double ADT (Lupron & Casadex) did not work for you. pjd, my husband, was diagnosed in Feb 2010, low psa (2.26) but high volume PCa (9/12 biopsy cores positive, many at 100%) with a 3+4=7 gleason. Negative bone scan & pelvic CT, but further testing showed the PCa was locally advanced outside the capsule to the rt seminal vesicle. He started triple ADT of lupron, casadex, and proscar (finesteride), one month ago (May 2010), with the plan being to add RT in a few months. Just got results back from one month follow up and PSA dropped from 2.26 to 0.314 (YEAH!). So appears the PCa is responding to the ADT.

Hoping to learn from your experience so a few questions: When you say the ADT stopped working, what did your tests indicate after 2 months on the drugs? Did your PSA and testosterone decline during the first month but fail to continue to decline in the second month? What were your PSA & testoserone levels prior to starting ADT and at one month and at two months post ADT? Assuming you had your nuclear bone scan prior to starting the Lupron & Casadex, you say it "lit up like a xmas tree," so guessing that meant, unfortunately, bone metastasis? If so, what was your doctor's thinking or plan on starting you on the ADT first, as opposed to starting the chemo (taxotere) first? Not trying to second guess here, just trying to understand the doctor's plan. What was your clincial staging prior to starting the ADT? I hope you will continue to post info about your journey and include the results of the 2nd opinion at S-K as it would be helpful to many of us. Thanks and wishing you all the best.
mrs pjd

pcinpa
Posts: 5
Joined: May 2010

Original discovery was a CT scan showing it had spread to the pelvic area and to the femur in both legs. PSA performed at the time was over 700. Had the nuclear scan the next day which showed it had spread all over my body. At that point my urologist started with casodex, but still had to do the biopy to confirm that PCa was the primary cancer. The biopsy revealed 2 out fo 12 cores at greater than 80%. The Gleason score was 9. Immediately following the biopsy, I received my first in jection of lupron. I had already been on finesteride for a number of years. After 2 months, my PSA dropped from over 700 to 7. Unfortunately, the following month it went back up to 33. The next month it jumped to 99. At this point my oncologist started Taxotere on 6/11/10. I am experiencing my first week of chemo. As a dear friend said to me, "this stuff is not for sissies". The standard protocol for my type of PCa is lupron & casodex. If it works it can give you many years. The side effects are minimal as compared to convential chemotherapy. As a conformation, the testosterone level at this point is <5 indicating that the lupron & casodex are working. The down side of all this is the high pain level. Percoset is now a close friend. I am very happy to see that the therapy is working for you. I will definiely make a post after my trip to S-K. Heres hoping they can pull a few rabbits out of the hat for me

I guess the most frustrating point is that I have been very proactve in my healthcare. I have had 7 biopsies in the last 10 years with the most recent prior to discovery at the end of January 2009.

Best of luck to the both of you and look forward to chatting in the future.

pcinpa

Trew
Posts: 892
Joined: Jan 2010

PCinPA, other than the CT was there any indication- pain, maybe?- that the cancer was spreading?

My gleason was a 9, too, with positive bladder neck- but the CT and bone scan were neg back in Feb of 09. I had surgery in March, 09.

pcinpa
Posts: 5
Joined: May 2010

A little back ground. Was working out at the gym at the end of December, 2009. Normally I wouuld start on the eliptical machine for a minimum of 35 minutes a a warm up to my weight lifting routine. After about 25 minutes, I became very tired and got off the machine. I became very lightheaded and my bp started to drop. They called 911 and into the ER I went. Since I had CABG in 2004, my doctor decided to admit me. Ekg normal,nuclear stress test normal, He indicated that some of my blood levels were slightly elevated and come back in a couple of weeks. The only complaint I had at that time was I had pain when I presssed on my chest. When I went to see my doctor, I was feeling "crapy" and thought I was having grastic pain. He scheduled an upper GI along with a complete blood test. The upper GI was negative. The alkaline Phosphatate test revaled a number over 1800. Normal is 0-40. This nunber either comes from the liver or from bone. The next test was the pelvic CT which showed that the cancer had spread to the bone. The nuclear scan determined how far it spread. The MRI of the tunor in my prostate was never really that large. The biopsy showed only 2 cores positive.
It never left the prostate. It spread through the blood. A very agressive tumor!

Be vigilent!!

mrspjd
Posts: 693
Joined: Apr 2010

Your comment about the most frustrating point being that you had been very proactive in your healthcare was similar to pjd's when he received the PCa diagnosis (dx). He said he felt his body had "failed him." Like you, he was proactive, having gone for his annual physical exams (with DRE by PCP and urologists) every year, had PSA's dating back over 15 years (although PSA levels were never a red flag as they were always lower than 2.8, with no rapid doubling), and had no major health issues, no RX meds, is physically active, golf, skiing, healthly lifestyle, etc. Even one month before the dx, he got a clean bill of health by an internist (who did the full exam). It took a new, very experienced, urologist to find a nodule on exam, then recommend the biopsy.

What were the results of your January 2009 biopsy and PSA? And what was the reason for the CT scan prior to the most recent (2010?) biopsy--pain?

This is a shot in the dark, but wondering if you (or any others reading this post) ever took the over-the-counter supplement DHEA prior to your dx? pjd took DHEA for two years prior to his dx and unfortunately we now know what a dangerous supplement it is for men who don't know they have PCa.

I, too, look forward to continuing this discussion.
Sincerely,
mrs pjd

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