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Re: Need info on Ketoconazole and hormone refactory
Your doctor does not think your Dad is hormone refractory.
Ketoconazole is a hormone treatment.
It is used when PSA rises on primary treatment while Testosterone is low (preferably under 0.694 nmol/L).
So it is called a Secondary Hormone treatment.
Cosudex or Casodex (bicalutamide), and anti-androgen, is an effective cancer killer until a certain point is reached, when it becomes an effective cancer food. So you stop bicalutamide.
Sometimes this is enough.
If not, the speed of PSA rise guides the doctor's choice.
Not too fast - sometimes a second anti-androgen (like nilutamide or flutamide) is tried.
A bit fast - secondary hormone treatment (like ketoconazole) is tried.
Too fast - chemotherapy with Taxotere (Docetaxel).
Where does the cancer get its testosterone food:
1. From the testes - stop with Zoladex.
2. From the adrenal glands - stop with bicalutamide.
3. The cancer cells eventually learn to use the bicalutamide as a food.
3. Cancer cells also eventually manufacture some testosterone on their own.
Note: I am not a doctor.
Just a fellow survivor
Hope this helps.
Jim
JimJimJimJim.com
Re: Need info on Ketoconazole and hormone refactory
Hi,
I have been fighting the long defeat for the past 3.5 years, 18 months of them on ketoconazole. It worked very well for me for that length of time with very limited side effects, mostly fatigue and a slight sense of dullness mentally. I am now on Xytiga, (Abiraterone Acetate) which has just been approved by FDA and in Europe I believe. You might want to suggest your dad try it instead of Keto, similar mechanism but stronger!
Re: Need info on Ketoconazole and hormone refactory
Thanks a lot Frank, Jim and Kevin. Your words and support mean a lot.
Abiraterone is not available in India yet as my sister found out. It will be by end of this year. However, if need be I can always try and get it from here(London, where I am) and send it to my dad who is in India.
As we await dad's next PSA, we just got worried thinking if there is a possibilty that PC is spreading to his organs? Although when he was diagnosed last year, it was spread in his bones and none of the organs. Incase it starts spreading, bones will be affected first? I am asking this since we might have his bone test done sometime in near future, should we also get an MRI done?
Also, what are the symptoms that we should look out for in case it is spreading (in organs)?
Thanks for all the support as always and hoping for the best for everyone here
Re: Need info on Ketoconazole and hormone refactory
Hello,
Its been a while since I have posted on this forum.
Dad's PSA continued to rise even after stopping Bicalutamide, thats when he was put on Ketoconazole. Since then, our family has been anxious, happy and worried. Anxious as we were waiting for Dad's PSA result after starting Ketoconazole, which lead to a drop from 7.5 to 6.5 in a month (Oct 2011). This is what made us all happy. Now the month 2 result (Nov 2011) has got us worried, Dad's PSA has gone up to 8. Just when we though Keto was working, we get these results. Confused and worried, we are getting his PSA done again tomorrow from another lab. Does PSA fluctuate like this while on Keto or is it something to worry about?
