ADT Side Effects & Different ADT Drugs

Angstromm

My brother-in-law has recurrent prostate cancer (he was originally diagnosed with stage 4a) and his oncologist wants him back on ADT drug he took for 2 years. Thing is the side effects were horrendous. From what I've read (NCI, ACS, etc.), side effects can vary some between the various ADT drugs. His oncologist said they all have the same effects.

What I'm wondering is if anyone else has had bad reactions to an ADT drug and tried another with and and few and/or less troubling side effects.

Clevelandguy

Hi,

From what others have stated the ADT side effects vary from person to person and you probably won’t know until he is on the drug for a while. If he had a bad reaction to the previous ADT drug, then maybe choose another one. There are several out on the market, he should discuss with his doctor.

Dave 3+4

Angstromm

https://csn.cancer.org/discussion/comment/1714632#Comment_1714632

Thanks much for the reply, Clevelandguy!

Yes, I've understood that there's variability from person-to-person in terms of side effects. And I agree that he won't know what any side effects will be until he tries a specific med and finds out. And I'm aware, as stated, that there are a number of ADT drugs available.

The question, however, still remains: Have folks who have tired more than one ADT drug found that one drug has fewer or less severe side effects than another. It's a given that everyone's experience will likely vary. All I'm trying to ascertain is if others have found there to be a difference in terms of side effects using different ADT drugs.

Old Salt

His oncologist said they all have the same effects.

Yes, as far as lowering testosterone, but many patients have reported that the side effects are not necessarily the same. I believe that Clevelandguy wrote essentially the same.

eonore

My radiologist at Dana Farber felt that the best way to alleviate side effects of hormone therapy is to be physically fit heading in and working hard during to maintain. Muscle loss is a real factor as testosterone disappears, keeping up resistance training will avoid the worse.
Eric

SuperDave

https://csn.cancer.org/discussion/327892/adt-side-effects-different-adt-drugs

I am new to this board, and it occurs to me that I am actually doing this experiment currently. Once diagnosed with a high-risk grade4 PCa, I switched to Penn Med and my RadOnc guy there prefers the lupron shots (extended release, quarterly injections) over my previous ADT drug, Orgovyx (oral, daily). So I stopped Orgovyx and started Lupron this week. Will report back with my anecdotal experience.

• Dave

Old Salt

Dave's point is of interest with respect to side effects.

Orgovyx is taken once daily as a pill.

Lupron is injected once every month, 3 months or 6 months. This has to be done 'just so' and patients have reported side effects just from the injection.

In conclusion, the statement of the oncologist that these drugs all have the same effects is grossing over important issues. In other words, the side effects reported by patients vary considerably (as Clevelandguy already pointed out).

Angstromm

https://csn.cancer.org/discussion/comment/1714646#Comment_1714646

Thanks, Old Salt. That was my understanding as well. My bro-in-law (just bro from now on) is going to seek a second opinion. His oncologist has consistently had a lackadaisical attitude…sigh.

And I guess I misunderstood Clevelandguy (sorry!). I had thought he meant that effects vary from person-to-person while taking the same drug, which the oncologist acknowledged.

Anyway, it definitely will be a good idea to get that 2nd opinion…

On_A_Journey

@Angstromm Although I'm not on ADT, I've done plenty of research in anticipation of being put on it one day. Like your bro, I am also experiencing a recurrence, but it's too early to do anything about it yet. I remain on active surveillance with quarterly blood tests.

There might not be much difference in side effects experienced by the same person between the different medications within a family of ADT drugs, for example Lupron vs. Zoladex in the case of LHRH agonists, but there can be a huge difference in side effects between the different families of ADT drugs. By that, I mean that if treatment was in the form of an anti-androgen such as Casodex taken as a monotherapy instead of an agonist like Lupron for example, the patient would experience far fewer sexual side effects and hot flashes and also maintain bone density, but might feel nauseous and might need to accept having breasts. Another family of hormone treatment, via good old-fashioned estrogen (Estradiol) will also minimize or eliminate the nasty side effects of the agonists and actually improve cognitive function compared to 'normal' men including the ability to multi-task! But it's feminizing effects may not be tolerable for some.

I firmly believe that every patient should be able to make an informed decision to take whatever drug suits their tolerance for certain side effects. For example, I dread hot flashes and cognitive issues, and if I had a choice I would select a drug that minimized those side effects, but unfortunately not every country permits the use of every different option.