Firmagon (Degarelix) substitute for Lupron

RADIATION HOPEFUL said:

Repeat

Hi Radhope, Balance what you are eating
Hi Radhope
I believe you are now more relaxed and prepared for the “T” day. You did your researches so you know about what you can expect during and after the treatment.
In your last post you commented that you have lost 20 pounds of weight due to your new diet. I would suggest you to balance what you are eating, particularly now that you will start your treatment. You need to be fit and healthy, so you should not avoid anything during this period. You can go back to your new diet once all is over and you are more in command of yourself.
I wish you the best.
VGama

VascodaGama said:

Hi Radhope, Balance what you are eating
Hi Radhope
I believe you are now more relaxed and prepared for the “T” day. You did your researches so you know about what you can expect during and after the treatment.
In your last post you commented that you have lost 20 pounds of weight due to your new diet. I would suggest you to balance what you are eating, particularly now that you will start your treatment. You need to be fit and healthy, so you should not avoid anything during this period. You can go back to your new diet once all is over and you are more in command of yourself.
I wish you the best.
VGama

DIET
Hello VGama
Thank you for the reply--appreciate it. I will try my best to stay fit & healthy.
I read a post yesterday entitled Prostrate Cancer Diary obout a individual that went through the radiation treatment. He detailed the exprriences encountered every day back in Oct. 2004 to Dec. 2005. I wrote him a memo & asked how he is doing today in 2011. He was kind enough to reply & informed me he now has leukemia. This scares me somewhat as to did I make the right decision to go with radiation? This coming Wednesday, I'm having the 3 gold seeds inserted then it's a couple days wait until I go to the hospital for a cast fitting. I don't know if they had such methods as gold seeds back in 2004 thus I sent another memo & asked ---didn't receive a answer yet.
Anyhow Thank you again for your reply. If you can add anything to what I noted , please respond.

RADIATION HOPEFUL said:

DIET
Hello VGama
Thank you for the reply--appreciate it. I will try my best to stay fit & healthy.
I read a post yesterday entitled Prostrate Cancer Diary obout a individual that went through the radiation treatment. He detailed the exprriences encountered every day back in Oct. 2004 to Dec. 2005. I wrote him a memo & asked how he is doing today in 2011. He was kind enough to reply & informed me he now has leukemia. This scares me somewhat as to did I make the right decision to go with radiation? This coming Wednesday, I'm having the 3 gold seeds inserted then it's a couple days wait until I go to the hospital for a cast fitting. I don't know if they had such methods as gold seeds back in 2004 thus I sent another memo & asked ---didn't receive a answer yet.
Anyhow Thank you again for your reply. If you can add anything to what I noted , please respond.

Leukemia as a Side Effect?
Hi Hopeful,

I can understand why the response from the man who underwent radiation several years ago and now has leukemia could be disconcerting. I don't believe scientists know exactly why leukemia develops and, of course, there are many variants. Tobacco use and exposure to large amounts of radiation are enviornmental factors that have been shown to increase the risk of leukemia. But the dosages that caused leukemia in many people, such as the Japanese who suffered after the atomic bombs were dropped in WWII, received a much, much higher full body dosage of radiation than what you would ever see in an IMRT enviornment. The fiducial placement will help your radiological team develop a dosage plan that minimizes radiation to tissue and organs near your prostate.

From the information you relayed, it's unclear what type of EBRT the other man had, whether or not it was to the general pelvic region or very accurately placed as is done in an IMRT procedure. We also have no way of knowing if there were other factors that may have caused his leukemia and whether it was in any way at all related to the radiation treatment he had.

I read of a study in France that looked at 13,000 patients who received EBRT in the mid-90s for various forms of cancer. From this group, 35 had developed leukemia by 2005. That's like 0.26 percent. As I recall, the authors could not asertain if there was a linkage to the radiation or not as the number was so low it approached the occurence of leukemia in the total population. As IMRT today is much more accurate that EBRT of 15 years ago I would guess that the risk is even less.

Of course you can't eliminate all risk and some people do indeed develop seconday cancers from radiation treatment. Some people (certainly not many) develop sepsis after surgery and die. I think it's a matter of understanding the risks involved with any treatment procedure and making a risk/reward analysis with your eyes wide open.

If you are very uncomfortable with this, perhaps you should pause or consider something else. My personal opinion is that we should be at peace with whatever treatment choice we decide upon. Most of us will continue to worry and have some degree of anxiety but if we're not convinced the course we're about to take is the best for us individually, then it's probably not the right course.

I am sure you will discuss this further with your medical team and I hope they can put your mind to rest about potential ramifications and long term side effects.

Best to you,

K

Medcomglen said:

Good to read your Good News!
That's wonderful you responded that fast. You may want to see if you can have a ProstaScint scan too with your other scans. Read my first blogs and you'll see why. In the meantime congrats to your Son, I just finished some great venison from North FLorida. Did you ever make it down to Sanibel? Wishing you and yours a Happy Holiday Season.
Glen

New at this
Hi Glen,
I am new to this posting. My husband, who is 61 and had normal psa levels every year, April 2010 was 1.0 was diagnosed with Prostate Cancer Gleason Score 10 with bone mets. He received his first Firmagon shot on 12/23 and is doing well. We saw the oncologist today who feels that right now Firmagon is the best choice of treatment avoiding chemo. Feels that quality of life can be maintained on Firmagon and depending upon how my husband's body responds to this treatment hopefully can delay chemo. Reading your postings are very positive to me which in return I share with my husband who isn't being so positive at the moment. I wanted you to know that your postings are helping me to think positive and thus try and keep my husband in positive spirits. Thank you

Kongo said:

Leukemia as a Side Effect?
Hi Hopeful,

I can understand why the response from the man who underwent radiation several years ago and now has leukemia could be disconcerting. I don't believe scientists know exactly why leukemia develops and, of course, there are many variants. Tobacco use and exposure to large amounts of radiation are enviornmental factors that have been shown to increase the risk of leukemia. But the dosages that caused leukemia in many people, such as the Japanese who suffered after the atomic bombs were dropped in WWII, received a much, much higher full body dosage of radiation than what you would ever see in an IMRT enviornment. The fiducial placement will help your radiological team develop a dosage plan that minimizes radiation to tissue and organs near your prostate.

From the information you relayed, it's unclear what type of EBRT the other man had, whether or not it was to the general pelvic region or very accurately placed as is done in an IMRT procedure. We also have no way of knowing if there were other factors that may have caused his leukemia and whether it was in any way at all related to the radiation treatment he had.

I read of a study in France that looked at 13,000 patients who received EBRT in the mid-90s for various forms of cancer. From this group, 35 had developed leukemia by 2005. That's like 0.26 percent. As I recall, the authors could not asertain if there was a linkage to the radiation or not as the number was so low it approached the occurence of leukemia in the total population. As IMRT today is much more accurate that EBRT of 15 years ago I would guess that the risk is even less.

Of course you can't eliminate all risk and some people do indeed develop seconday cancers from radiation treatment. Some people (certainly not many) develop sepsis after surgery and die. I think it's a matter of understanding the risks involved with any treatment procedure and making a risk/reward analysis with your eyes wide open.

If you are very uncomfortable with this, perhaps you should pause or consider something else. My personal opinion is that we should be at peace with whatever treatment choice we decide upon. Most of us will continue to worry and have some degree of anxiety but if we're not convinced the course we're about to take is the best for us individually, then it's probably not the right course.

I am sure you will discuss this further with your medical team and I hope they can put your mind to rest about potential ramifications and long term side effects.

Best to you,

K

Radiation ASpects
THank You to both Kongo & VGAMA for the postings about my radiation decision. As both of you indicated ---we are individuals & the results may never be the same for all. We are snowflakes in essence & I appreciate that.
I'm stickig with my choice & preparing to have the three gold seeds inserted going forward with the radiation. I understand whatever choice I made , each has it's side affects. My family doctor told me he had his prostrate removed but was considering radiation informing me the outcomes were basically the same. He chose removal years ago in N.Y. in order to get back to work ASAP without taking radiation treatments.

I didn't hear back from the man I wrote to regarding his leukemia status. If I do, I'll post what I found out.
Thanks again to both of you for posting the enlightening info--I truly appreciate it & wish the best to all.

Question> Did either of you have to sign a consent form for the seed placement? There is one statement that reads> Because medicine is not an exact science, no guarantee can be made regarding the results & the risks involved with this procedure are Infection, Bleeding & Urinary retention.
It's probably a standard form but it sure scares you. Hope he can place the 3 gold seeds so they don't hit the urethra.

Rad Hopeful

Kongo said:

Consent Form
Hopeful,

Yes, I certainly did sign an informed consent form for seed placement. The seeds are placed with ultrasound guidance. I wouldn't worry too much about them hitting the urethra as they have a pretty good view. BTW, seeds are not unique to prostate cancer. They are placed frequently anywhere in the body whenever a soft tissue tumor that is subject to movement exists.

Best,

K

3 Seeds
THank YOu Kongo

You are very knowledgeable & helpful--Appreciate the post. I hve to take a antibiotic called cipro the day before , the day of & the day after the 3 gold seed insertion along with flagyl. I'm anxious to find out if the prostrate shrank any since taking the hormone drug.

Thanks again

Rad Hopeful

VascodaGama said:

Radhope; Ask advice about any preparedness
Hi Radhope
Firmagon shrinks the prostate to a small extent. Firmagon (Degarelix) is a GnRH receptor blocker (similar to Eligard) that will stop the fabrication of testosterone at testis, and therefore, reducing the testosterone in your body. Finasterine which is a drug of the group 5-alfa reductase inhibitor is used to inhibiting the “fabrication” of the Dihydrotestosterone (DHT) at the prostate and it reduces the size of enlarged prostates (BPH).
The low testosterone in your body will starve cancer cells to die as these live of testosterone. However some cells can survive because the adrenal glands also produce about 5% of the testosterone in our body.
The radiation therapy will confront a weaker tumor (applauses to firmagon) and it will eradicate the cancer.

On Wednesday, you can ask advice from your doctor about any preparedness. I recall that I was recommended of drinking lots of water one hour before each section to have the bladder filled (protection ????). I used to drive to the IMRT facilities clinic (50 km far from my home), and be finished in about 20 minutes (3 under radiation).

Good luck.
VGama

Preparedness
Thanks VGAMA for the post

Tomorrow I'm scheduled for the three seed placement & will ask questions.
My first urologist didn't know about Firmagon & was going to give me Lupron. Glad I switched because the Firmagon appears to be working as I indicated first shot --dropped PSA from 55 to 17.
I don't know why but I'm now going to the bathroom with a strong stream. Perhaps the prostrate shrank some?
I still feel good -very mild side affects --"THANK GOD"--now I start the long journey into the unknown affects of the radiation in hopes of eliminating the cancer.
Only time will tell & I'll keep all posted. Thanks again for the advice

Rad Hopeful

Medcomglen said:

Latest PSA results
January 10, 2011; 1.3
November 16, 2010; 0.7

Last Firmagon injection,80mg: September 2010

RadHope; Great news about the seeds
Radhope,
Congratulations. Great news about the seeds. Smooth, simple and no pain. Just perfect. You will be ok.

Regarding Eligard, I am doing find. I think you are more worried than you should. The difference between Firmagon and Eligard are two;
(1) Firmagon gets patients quicker to castrate levels in just 48 hours (no cause of “flare”), whether Eligard causes “flare”. Meaning that the testosterone first goes up before starting to go down, in about 10 days. Because of the “flare”, patients in advanced cancer status (ex: cancer in the spine bone or in the urethra) could experience bone pain or difficulty in urinating. To avoid this (flare), doctors prescribe an antiandrogen to be taken for one or two weeks before the Eligard shot. Even though, this practice is done usually in cases of advanced cancer, my doctor prescribes all his patients to take Cyproterone (Androcur) 2x50mg daily for two weeks before the shot (Eligard, Lupron, etc).
(2) Firmagon has only a monthly shot (I read that they are preparing shots for longer periods). Whether Eligard are manufactured for one-month, 3-months, 4-months and 6-months shots. This possibility of several applications permits better scheduling of protocols and that it also avoids monthly painful injection.

I start taking Eligard (6-month shot) in November 2010. So far the only side effects I have experienced were caused by the low level of testosterone; Fatigue during three weeks (now gone), and mild Mood changes. As I commented before, I am active in physical fitness to help me in combating the side effects. I walk almost every day approximately 7 to 8 km (3 x 2.5) with my dog and play golf on week-ends. I believe in fitness for caring of prostate cancer.

Both drugs, Firmagon and Eligard have the same principle and may differ slightly when in action in our body, but the side effects caused by the drugs are only natural in patients on long term hormonal therapy (my case not yours). One could expect equally from both; Redness and Swelling at injection spot, Fainting, Irregular heartbeat, Hypertension, Insomnia, Decreased red blood cell count, and Dizziness.

You can see on these sites descriptions of Side effects caused also by the low levels of testosterone;
http://www.eligard.com/side-effects/eligard-side-effects.aspx
http://www.drugwatch.com/firmagon/side-effects.php

Hope my explanations answer your question.

Take care
VGama

VascodaGama said:

RadHope; Great news about the seeds
Radhope,
Congratulations. Great news about the seeds. Smooth, simple and no pain. Just perfect. You will be ok.

Regarding Eligard, I am doing find. I think you are more worried than you should. The difference between Firmagon and Eligard are two;
(1) Firmagon gets patients quicker to castrate levels in just 48 hours (no cause of “flare”), whether Eligard causes “flare”. Meaning that the testosterone first goes up before starting to go down, in about 10 days. Because of the “flare”, patients in advanced cancer status (ex: cancer in the spine bone or in the urethra) could experience bone pain or difficulty in urinating. To avoid this (flare), doctors prescribe an antiandrogen to be taken for one or two weeks before the Eligard shot. Even though, this practice is done usually in cases of advanced cancer, my doctor prescribes all his patients to take Cyproterone (Androcur) 2x50mg daily for two weeks before the shot (Eligard, Lupron, etc).
(2) Firmagon has only a monthly shot (I read that they are preparing shots for longer periods). Whether Eligard are manufactured for one-month, 3-months, 4-months and 6-months shots. This possibility of several applications permits better scheduling of protocols and that it also avoids monthly painful injection.

I start taking Eligard (6-month shot) in November 2010. So far the only side effects I have experienced were caused by the low level of testosterone; Fatigue during three weeks (now gone), and mild Mood changes. As I commented before, I am active in physical fitness to help me in combating the side effects. I walk almost every day approximately 7 to 8 km (3 x 2.5) with my dog and play golf on week-ends. I believe in fitness for caring of prostate cancer.

Both drugs, Firmagon and Eligard have the same principle and may differ slightly when in action in our body, but the side effects caused by the drugs are only natural in patients on long term hormonal therapy (my case not yours). One could expect equally from both; Redness and Swelling at injection spot, Fainting, Irregular heartbeat, Hypertension, Insomnia, Decreased red blood cell count, and Dizziness.

You can see on these sites descriptions of Side effects caused also by the low levels of testosterone;
http://www.eligard.com/side-effects/eligard-side-effects.aspx
http://www.drugwatch.com/firmagon/side-effects.php

Hope my explanations answer your question.

Take care
VGama

THANKS FOR THE POST
VGama

Thanks once again for the info, I questioned the change of one drug (Firmagon) to the other (ELigard) & was told the Firmgon is only used to suppress the PSA while the Eligard will stop total testesterone production.
I also try to stay active & got scared of what I read about the Eligard. Very happy to hear you are taking the drug without serious side affects.
Since I start the radiation next week I really didn't want to change hormone drugs. Can you tell me what dose you are taking --the 1, 3-4, or 6 month injections?
I believe you get the PSA flare based on the amount of the drug you receive. The one month injections have a low dosage while the multiple months are high thus placing a strain on your entire system. But again why change if one is working & lowering the PSA along with shrinking the prostrate---this is what bothers me. Another concern is I'm just a little guy weighing in at 120lbs. (lost 20 lbs. since November)& would have a much more severe reaction than say a 200lb. man. I'm also taking heart medication for irregular heart beat & fear taking chances. I have very few side affects using Firmagon (don't know what the PSA reading is from the second shot)& have a request in for the doctor to contact me regarding the change. I believe I mentioned earlier I had Lyme disease a few months ago (JULY2010)& still have residul side affects such as nerve damage to the fingers. I'm afraid taking the Eligard could result in even further nerve damage since this is one of the side affects---not so with Firmagon.Thanks again for the post----prayers & good wishes to all having this terrible disease.
Rad Hopeful