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Prostate cancer after liver transplant: Concerned about ADT treatment
I started the Eligard about 3 weeks ago and I'm waiting on the Zitga/Prednisone combo until I have an ERCP done as I had a Liver transplant 14 months ago. Taking the Eligard has me felling uneasy. Not sure I want to go through all of the side effects that come with the 3 meds. I want to get my liver on its best path, which it's heading that direction, before starting a medication that can damage the Liver. I'm considering doing all 3 medications and postponing the radiation until I find out if my Liver is going to be affected. Don't want to start Radiation while on the Zitiga and have liver issues which would take prostatectomy off the table or make it extremely complicated, as I understand. Taking both meds with radiation gives me the best chance but taking only the Eligard reduces my chances of success where it might be better to remove the prostate. Don't know if this path is advisable with Gleason score of 4+4 and PNI. PETSCAN from 9/19/25 showed that it hasn't spread.
Comments from anyone with a similar situation? Any input would be greatly appreciated.
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@williemac, I made your question into its own discussion. I see your conundrum of taking hormone therapy for prostate cancer after liver transplant only 14 months ago. First of all, congratulations on the new liver. I can understand your wanting to protect your new liver.
While not prostate cancer specific, I'm tagging fellow transplant members like @smithpamelag @rachel5239 @shelbs16 who were diagnosed with cancer after transplant.
Williemac, is your oncologist in communication with your transplant team? Have you made any decisions about treatment?
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3 Reactions@colleenyoung I am actually 38 years post transplant. I consider myself very lucky. I was just diagnosed with breast cancer. I was on the fence about doing any treatment. My family was not happy about that. So I am starting chemo on Friday. I would die if I did nothing and if I die after this, at least I tried.
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2 ReactionsYou’ve already started on Eligard (which will result in your testosterone being suppressed; your PSA should follow). So, that horse is already out of the barn (so to speak).
> You’re waiting on the Zytiga (Abiraterone)/Prednisone until your ERCP test results. (If it were me, I would wait until those results come in rather than running in circles around “what if’s.”)
Has your doctor recommended minimizing the Eligard side-effects with resistance-training exercises?
The Zytiga (Abiraterone) has its own possible side-effects. (See attached chart.)
Has your medical team said anything about liver issues with Eligard?
Has your medical team said anything about liver issues with the Zytiga (Abiraterone)/Prednisone combination?
Again, if it were me I would let the data and test results guide your path, rather than “what if’s.”
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1 ReactionYou should consider ITA only if your transplant doctor is informed about what is going on and your oncologist is made aware of the dangers involved after a transplant.
Yes, Zytiga (abiraterone acetate) can have negative effects on the liver, causing elevated liver enzymes (ALT, AST) and bilirubin, which are common but usually managed with monitoring, dose adjustments, or stopping the drug; rare but severe cases of liver failure can occur, highlighting the need for regular liver function tests, especially in the first few months of treatment.
Common Liver-Related Effects
Elevated Liver Enzymes: Increased ALT (alanine aminotransferase) and AST (aspartate aminotransferase) levels are common, occurring in a significant percentage of patients, often within the first three months.
Symptoms: Some people experience jaundice (yellowing of skin/eyes), dark urine, nausea, vomiting, abdominal pain, or fatigue, though liver damage can happen without symptoms.
A couple of articles about this
https://resources.healthgrades.com/drugs/zytiga-side-effects.,abdominal%20pain
https://www.medicalnewstoday.com/articles/drugs-zytiga-side-effects.
@colleenyoung Thanks for forwarding my post! My transplant team is aware of my situation and I have a CMP, CBC, PSA, and Testosterone done every 2 weeks. They are on top of both health issues. Since my post I spoke to a urologist with Mayo and they agreed that just doing the eligard for now with radiation would be a good path. They liked the idea of not taking the Zitiga at this time to not only protect the liver but also have that as an Ace in the hole to use for treatment down the road if needed. This discussion was communicated to my Medical and Radiation Oncologists and they are very comfortable with that path forward.
My PSA is at 0.44 and my testosterone is at 5 one month after starting the Eligard. I will start 28 sessions of radiation on January 29th. It was nice to have a conscience between Mayo and my team which made me feel as good as one can feel about the path forward.
Thanks!
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2 Reactions@jeffmarc Thanks! both teams are aware of what I'm going through and they communicate with each other. After transplant I was required to have blood work done weekly for the first year and now I'm cut back to every 2 weeks. Now I do PSA, Testosterone, CMP, and CBC every 2 weeks. Spoke with Mayo and they said that considering my situation they would treat me similarly to how my team is suggesting. They liked the idea of not taking the Zitiga and having it as an option down the road if needed. After one month on the Eligard thing are progressing as they would like to see. PSA is 0.44 and Testosterone is at 5. I will be starting 28 rounds of radiation on January 29th.
Thanks again for your post!
@brianjarvis Thanks! We are doing like you said, we are letting the data plot the best path forward. My PSA after one month on Eligard is 0.44 and PSA is 5. ERCP is done and I need at least 2 more so we are leaving the Zitiga on the back burner for now so it may be use later if need be. The side effects of the Eligard are subsiding and I"m doing some physical conditioning.
Zitiga is known to cause liver issue albeit rare.
Starting 28 rounds of Radiation on January 29th to hopefully kill the cancer.
Thanks again for the post!