Lupron frequency
What is the usual frequency of Lupron injections usually given to a guy with recurrent prostate cancer ? One month, three months, four months or six months ? I’m on my second recurrence and my PSA is at 1.18. Thank you. Stephen.
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That is your decision in coordination with your medical team...
Generally, the Lupron injections can be 1, 3 or 6 months.
Choosing which one can be a function of several things:
1. Your ability to get to your doctor's office for the injection - health, distance, transportation.
2. Whether or not you want some degree of flexibility should you decide to stop, if yes, one month, if no, six months
3. Financial toxicity - besides the cost of the drug, there are various other administration costs associated with the nurse and doctor who are involved.
Others may chime in with their experience when they were on Lupron. I was on it for 18 months, Jan 17-May, 18, chose the 90 day shots in part for reason 2 as it turned out our original plan was 24 months but we stopped at 18 given my response, PSA undetectable with the first injection and stayed there.
My time on these forums during the ten years of my journey doesn't show a "difference" in the side affects between the shots or recovery once it clears, a lot of anecdotal comments so I didn't include that as #4.
You didn't summarize your treatment history so the forum members can't provide input on your treatment. I will say that mono-therapy for recurrence is generally out of date, some combination of doublet or triplet therapy may be in order, depends on your clinical data.
There is an oral alternative, Orgovyx which has advantages over Lupron:
No Flare
Faster castration
Higher sustained castration
Lower CV side effect profile
Faster recovery of T if you recover) once stopping.
It can be expensive, depends on your insurance.
Kevin
Thanks for your information! I had a Prostatectomy in 2006 . PSA was 5.53 . Gleason 3+4=7. I was in remission until 2013 when PSA went to 0.22 . I then had 39 radiation treatments to my prostate bed. Went into remission again for 2 years. My PSA level slowly rose again to the current 1.16. Waiting on PSMA results. Doctor said Lupron would be my next treatment.
Some things to thing about...
two important pieces of clinical data that may be useful in your decision process in coordination with your medical team:
PSA Doubling Time and PSA Velocity...you say you had SRT in 2013, went into remission until 2015, since then your PSA has risen to 1.16. That would indicate a very "indolent" PCa. You can use the SMKCC nomogram to calculate it - https://www.mskcc.org/nomograms/prostate.
When you get the PSMA scan results, that can inform your decision...
Attached is my clinical history, in March of 2023 my PCa came back after 4-1/2 years off treatment. The Plarify scan showed a single LN. Based on that and my clinical history, Grade Group 4, we decided to do SBRT and 12 months of ADT - Orgovyx.
There are some studies which may lead you to a decision (depending on the scan results) to treat with SBRT only, this may delay the need for systemic therapy and all the fun that goes with it!
The scan results may also lead you to a decision to combine SBRT with a limited time of ADT, 6, 12, 18, but not more than 24 months.
The clinical data you provide may not warrant triplet therapy - SBRT, ADT with an ARI or chemotherapy.
My triplet therapy included chemotherapy because I was GG4, short time to BCR and rapid PSADT and PSAV. Use the nomograms to aid in your decision making.
I would challenge your medical team to explain "Lupron would be your next treatment" when they don't have your scan results and how clinical data such as PSADT, PSAV, GG2...
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=34&contentid=16288-1
Based on these differences, healthcare providers have started to use a newer system that breaks up prostate cancers into 5 grade groups:
Grade group 1 = Gleason 6 (or less)
Grade group 2 = Gleason 3 + 4 = 7.
Grade group 3 = Gleason 4 + 3 = 7.
Grade group 4 = Gleason 8.
Grade group 5 = Gleason 9 or 10.
Kevin