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Hi Al ... last year I underwent the exact protocol you're planning ... hormone therapy with monthly Lupron injections for six months and then seed implant followed by five weeks of external beam radiation.
I had no depression or weight gain/loss while getting the Lupron shots but the others are right ... no sexual desire or ability, at all. That's indeed a very strange sensation.
The hot flashes were bad but tolerable in my case. By the way, you'll get no sympathy from menopausal aged women when you complain about hot flashes.
I did have one other rather strange symptom from the Lupron injection. For two days after the shot in the hip, that leg hurt around the injection site. It hurt bad enough that I actually used a cane for support. The third day it completely disappeared. My Urologist didn't understand it but it was real.
I was asymptomatic right up to the day of the seed implant. My urinary function worked perfectly. The day after, however, that all changed.
I started taking Flomax immediately with little relief. I had the main four problems ... urgency, frequency, pain and burning from the day after the seed implant right on thru till the end of the daily radiation treatments.
Although not actually incontinent, when I had to go, I had to go right then. I was up hourly every night so sleep deprivation was also a problem and added to the next problem, fatigue.
I drive a wheel chair van three days a week transporting senior citizens to medical appointments so these problems definitely interfered with my ability to continue doing that. By the third week of radiation I had to stop working altogether due to the urgency/frequency problem.
Those vans don't have porta-potties on them.
I recovered nicely from the seed implant and had the catheter removed the following day.
The radiation was interesting ... space age looking stuff. Each treatment only takes about ten to fifteen minutes and is painless.
I talked with others that had been thru it at the time and they all told me that fatigue would be a problems and it was. By the third week the fatigue, both from the treatment and lack of sleep, took it's toll.
As soon as the treatments were completed the fatigue went away almost immediately but it took several more weeks for the urgency/frequency urination problem to begin decreasing.
I had the seed implant last October and completed the radiation treatments in January of this year. The urgency/frequency is now controllable but the pain/burning continues with, literally, good and bad days.
Regarding the Flomax, I went from one pill a day to twice a day during the radiation treatments, back to one a day following the treatment and am down to one pill every other day for several months now.
The only side affect of Flomax, for me, was sinus headaches, bad ones that required a prescription strength spray, Veramyst, for relief. Taking Flomax every other day virtually eliminated the headaches and the need for Veramyst.
My PSA went from 115 to 3 as of July. My sexual desire has returned but ED continues to be a problem.
I was really nervous about that until I joined this site and found out that it could take a year or more for normal functions to return ... something the medical folks conveniently forgot to tell me.
Hi Al,
My treatment was different, was on 3 month Lupron Depot shots to the hips for one year, last shot April o8. All the responses are about right. I still have hip pain, which hurts when ever I walk a couple of miles or more and ride my bike 5 to 7 miles, usually about 50 mins of exercise. It did not mater if I exercised or not, I was still very tired, one or two naps/day. So far not much sex drive, am to test the PSA and Testos this week, do not expect much the way I feel. Talk to your Docs about depression early, I had to beg & plead for help, from my HMO!
As you can tell, everyone reacts a little differently.
Hope you are hit lightly with all this. Be thinking about you. YANA!!!!
Joe
George's post gives some hope (thanks for sharing...)
Three follow-on questions:
1. On the weight gain it seems that some of you were able to take weight off after gaining it.
Had you been on a normal or maybe a higher calorie diet and then restricted calories and increased exercise to lose the weight? It seems that by dropping daily caloric intake that you should be able to manage the weight or does Lupron have you gain weight even off of a restricted calorie diet?
2. What helped with depression and low mood?
3. Assuming ability to take naps and not too severe urinary symptoms were you still able to maintain a normal work schedule throughout treatment?
Prior to the treatments, I ate a moderate diet and jogged daily. During the treatments, I ate anything I wanted. I needed the energy and I wanted to baby myself since things sucked at the time. Part of my rapid weight loss may have been due to the return to a normal diet. I know I wasn't able to exercise normally for quite a while.
The only thing that helped with depression was therapy. I saw a clinical social worker every week. We talked about my anger and depression as well as the changes in my life. We also mapped out what I had to do to return to a normal life.
I was able to go to work every day during treatments. I'm an engineer and I work at a desk mostly. I was tired during the day and beat at night. I had to stop doing many things to conserve energy. No exercise, shopping, yard work, family visits, etc.
Just heard back from my urologist. Turns out he will put me on Trelstar 11.25mg every 3 months along with a daily Casodex.
I am assuming this doesn't change the picture that has been described in either direction? Would once again appreciate any experience or knowledge of the difference of Trelstar/Casodex to Lupron.
Trelstar and Lupron both imitate LHRH(Leutinizing hormone releasing hormone) which is intermittently secreted by the hypothalmus as a response to low testosterone level. LHRH then activates the pituitary to release LH (Leutinizing hormone) which stimulates the testes to produce testosterone.
Trelstar and Lupron both constantly bombard the pituitary and trick it into shutting off the LH to the testes resulting in a lack of testosterone production.
Casodex further reduces testosterone by attacking the 5-10% of testosterone that would still be produced by the adrenals molecules.
I would say that LHRH analogues like Trelstar, Lupron, and Zolodex are probably equal as far as side effects and effectiveness, one would probably decide on one brand depending on insurance and Dr. preference.
Although there are several indications for Casodex usage, the one I received advice and literature on was testosterone flare. Trelstar, etc. cause testosterone flare that can be life-threatening or very painful if there are significant mets or alarge tumor in the prostate. For me, getting CAT and bone scans done Before any ADT was administered let me rule out Casodex. There weren't any areas on the scan of concern.
I'm sure there are probably other reasons for adding Casodex to the initial treatment prior to radiation but I'll have to let others speak for them. Take care - p (Alaska, USA)
