CSN Login
Members Online: 11

You are here

Bicalutamide (Binarex, Casodex)

bouden's picture
bouden
Posts: 5
Joined: Nov 2018

I underwent a salvage radical prostatectomy in March 2017. Subsequent complications with anastomosis scarring required a Bladder Neck Incision followed 6 months later with a second and steroid injection to permanently open bladder neck. I was fitted with AMS800 in September 2018 and activated 6 weeks later. I can now sleep through the night, and an able to get by with 1 Level one pad most days.

However, sitting on hard seats (like church pew, or very firm padding) and scrunched up in car driver's seat causes problems when I stand up. There is often more than a dribble. It seems as though the pump is activated accidentally. Is this possible/likely, especially if you have been sitting for an hour or more desk-working or driving?

Pleased to hear if anyone has the same issues.

Also, my PSA starting increasing again after RP, with a 3-month doubling. Currently on Bicalutamide 150g which dropped PSA to .03 as at November 2018. I see the surgeon later this month and hope the PSA read has not changed - but must wait and see.

Has anybody else undergone this 'chemo' and what was the outcome?

VascodaGama's picture
VascodaGama
Posts: 2945
Joined: Nov 2010

Bouden,

Welcome to the board. Your inquire has been discussed here several times. In regards to the AMS800 experiences you may want to read/participate in below links dealing with the experiences of many users. You can even place there your question or try contacting participants via the CSN mail.

https://csn.cancer.org/node/299789

https://csn.cancer.org/node/255231

https://csn.cancer.org/node/226707

https://csn.cancer.org/node/255231

In regards to the antiandrogen Bicalutamide, it works by prohibiting the cancer from absorbing androgens. It is a good monotherapy but it is palliative (it does not kill the cancer). It manages to control the advancement of the bandit during many years if one's type of cells is hormone dependent. You did not share your PSA histology to compare the values but a decrease to 0.03 ng/ml signifies that you are at remission levels.

I hope your doctor gives you satisfying answers to your doubts in your next consultation. We can help if you share more details of your initial diagnosis, treatment and present status. What is your age?

Best wishes and luck in your journey.

VG   

bouden's picture
bouden
Posts: 5
Joined: Nov 2018

Vasco, thank you. I suspected the issue may have been discussed before. You have actually answered me the nub of what has been my problem - Bical is palliative only. Trawled throgh masses of medical and pharma literature but none of it really answered my question. However, I will be seeing the surgeon shortly so will be better armed with questions. For the record I am 72 (in 2 days time)

As to PSA quoting my surgeon's notes ... "level is now 1.05ng/mL (May 2018) it was 0-04ng/mL back in June of 2017 so the doubling time is quite significant arounf three months". Bical wa started after this consultation, Test on 2 Aug '18 was 0.04, and test 27 Sept was 0.03. I expect to be requested to undergo a further blood test (may be liver, renal, etc as well as PSA) before the upcoming consult.

Josephg
Posts: 138
Joined: Jan 2013

Hi Bouden,

Your leakage issues are most likely being caused by pressure being applied to the AMS800 cuff afixed to your urethra, when you sit on firmer/harder objects.  At that point, the pressure on the cuff has already allowed some urine to get past it, and when you stand up, gravity moves the passed urine out of you.  I use a gel pad on my desk chair, where I generally spend the longest periods of time sitting.  That seems to dramatically reduce the pressure on the cuff for me.  I do not have any isues with leakage while in my car.

Living with the AMS800 is a learning process, trial and error, which can take up to a year for you to master.  You will learn how to adjust your sitting over time to minimize the leakage.

The most important point here is:   Are you substantially better off now in terms of quality of life with your AMS800, than you were before you had it implanted in you?

bouden's picture
bouden
Posts: 5
Joined: Nov 2018

Thanks Josephg. You have given me another point to consider - pressure on the cuff forces the fluid out, similar to the pump, and therefore opens up the urethra as for the normal toilet. Had a session just this morning. Hour's drive and topped to use public loo. By the time I was clear of the car I had soaked myself. Most annoying as had to cancel brunch and head home for a change of gruts, pad and trou.

VascodaGama's picture
VascodaGama
Posts: 2945
Joined: Nov 2010

Bouden,

If I read it right, the histology is this:

March 2017,(PSA=?) Radical prostatectomy (RP)
June 2017, PSA= 0.04
May 2018, PSA= 1.05; Recurrence declared, started bicalutamide (150mg/daily)
August 2018, PSA= 0.04
September 2018, PSA= 0.03 ng/ml

I wonder the results of any image exam done before RP. In any case, the decrease of the PSA has been significant since the start of bicalutamide (ADT monotherapy). That means that the cancer is hormone dependent so that you can expect several years of control using ADT drugs.

In recurrence cases doctors usually recommend salvage therapy with radiation that can kill the bandit but this may not be proper to you for the previous bladder issue. Your doctor may have decided to control the recurrence with ADT (hormonal treatment). He may have chosen a softer approach with bicalutamide monotherapy as this cause lesser side effects than the traditional agonists (like Lupron) which leads to chemical castration. The daily pill is working and may be enough in your case. However, you should be vigilant with timely PSA tests (commonly every 3 to 6 months) because bicalutamide can lead to mutation of cell’s androgen receptors, and subsequent refractory.
Some patients have reported using bicalutamide successfully over 10 years. I hope you are one of them. In any case, at first sign of increasing PSA you should then change antiandrogens (probably to Xtandi) or add other drugs (agonists) to block the manufacturing of testosterone (feeding the cancer). The sequential ADT would give you another long period of palliative treatment at the cost of extra side effects but with quality living.

In regards to your added tests, I would recommend you to get a full lipids panel inclusive of a Testosterone. DEXA scan is also recommended for guys that will be on ADT for many years to check any influence on bone loss. Some patients on osteopenia add a bisphosphanate to the protocol from the start.

You can inquire with your doctor what are the prospects in the long run. Also inquire about additional tests so serve you as baseline. For the time beeing you are in Remission. Congratulations.

Happy birthday.

VG

 

Subscribe to Comments for "Bicalutamide (Binarex, Casodex)"