50 mg Casodex and Tamoxifen taken together

rulesdabeach

Hello everyone I'm Michael, I hope you are all getting helpful responses to all of your inquiries.

I was diagnosed with stage 3 inter ductal carcinoma and had a total radical prostatectomy and on followup at Perleman Cancer Center UPENN my PSA went back up I was prescribed Lupron (which I refused) and 35 days of radiation. Subsequently after the radiation my PSA didn't go down and after multiple bone scans in the hopes the cancer wasn't in my bone or brain (which there was not metastis) I was put on 50mg Casodex (bicalutamide). It seems to be working well as my PSA has gone bak down to as low as 0.05 from a high post surgery of 1.35 if memory serves. I'm experiencing the side effects especially gynecomastia which is aesthetically bothering me as well as areola pain (I know a small price to pay vs Lupron).

My question is, has anyone been prescribed Tamoxifen to reduce the gynecomastia? Additionally, if so has it been effective in reducing the breast tissue. I say "there's always someone worse than me" and I don't ever complain. I'm grateful for any and all responses to my question. Thank you all and may you all receive answers so that we may all thrive for a long life. - Michael

On_A_Journey

Hi Michael,

Sorry that no-one had replied yet. I've done a heap of research into the side effects of all the different sorts of hormone therapy for prostate cancer, in readiness for myself to one day go on it. I have a biochemical recurrence after my failed prostatectomy in 2015 and follow-up radiation without hormone therapy in 2016. My PSA eventually fell to 0.04 in 2018 but now it is up to 0.58 and climbing slowly. It was a couple of years ago now that my oncologist said that the next step for me would be hormone therapy if a scan couldn't detect where the cancer is.

Anyway, what I do know is that the most severe side effect of Casodex is indeed gynecomastia, but the rest of the side effects are a walk in the park compared to Lupron. Like you said, a small price to pay. The most severe side effect of Lupron or Zoladex is hot flashes. Now, get this - a common side effect of Tamoxifen is hot flashes, also the other side effects that you avoided by not taking Lupron, like weight gain, fatigue etc. etc. So, Casodex = 85% chance of boobs but not much else, Lupron = 20% chance of boobs but almost guaranteed horrible hard to live with other side side effects including sexual dysfunction, Casodex + Tamoxifen = the boobs you already have + most of the Lupron side effects anyway!

I have learnt a lot about gynecomastia itself too. If you can reach a level of self acceptance with it, it won't be a problem. And, there is absolutely nothing wrong at all, if you end up with breasts that are large enough to need support and freedom from irritation, with treating them the same way as a woman would. Socks are for feet regardless of gender, gloves are for hands regardless of gender....you know where I'm going with this.

Keep an open mind and enjoy your lack of nasty side effects!