Lupron Treatment Duration: How long were you on it?

Posted by frankstags @frankstags, Jul 7, 2020

I have been diagnosed with Grade 3 prostate cancer with a 4 + 3 Gleason score of 7. This after having 2 PSA scores last year between 4 and 7. The cancer has not spread to the bones. I have received two Lupron injections 3 months apart and will complete 28 radiation treatments in the next couple of days. No surgery. I have tolerated the Lupron shots well with few but manageable side effects. I have an appointment to receive a third Lupron shot next month. My first PSA test after completing radiation won't be scheduled for 3 months. From researching Lupron, it appears that this is used for advanced stages of prostate cancer. From what I was led to believe, I was not advanced. My question: How long and how many Lupron shots might I need to go through? I will have this discussion with my urologist hopefully before proceeding with the next shot. Thanks for any information provided by the group.

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I'm 8 mos post surgery, started at psa 13.5 gleason 4+3. PSA started back up around 6 mos after surgery from .039-.091, had a clear PSMA PET CT and started radiation.

I'm on orgovyx instead of Lupron, but, in a recent conversation with my urologist he answered the how long questions with anywhere from 6 mos to 2 years max. It seemed the decision had more to do with my QOL and tolerance for the drug than anything else.

The radiation oncologist also told me that the decision was entirely mine and statistically, the percentage of better outcomes in my situation are only 3%-5%. My feeling is "give me everything ya got doc" at this point.

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@drj

There's a long time adage about PCa: "If you can cut it out [prostate/PCa] and put it in a jar, you've cured it". That 's long been my mantra and my anticipated choice while working in the prostate Ca field. And that seems obvious if you are highly certain your PCa is confined to the prostate. Yet, when my surprise turn came at 79 yrs, with 30 years of monitoring PSA, a rising PSA over 4 yrs to 7 ng, led to a Gleason of 4+5, but a clear PSMA PET scan forced me to review this long held idea of the choice I would make. My final decision was based on three things; Fewer side effects with radiation (although ADT is not benign due to side effects), greater confidence in ruling out metastases (PSMA PET), and significant improvements in targeting the radiation (5 days at higher dosage) and minimizing the likelihood of side effects (e.g. Hydrogel placement, etc). So, a comparison of side effects flipped my prior assumptions of my treatment choice. Note: Advances have be sufficiently rapid that I found it difficult to make decisions based on published data in the literature because my judgement was they often do not reflect these current improvements.

Good luck to you both.

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Thank you for taking the time to answer my post in detail. I have read it more than once and consider it my introduction into this new phase of our lives. The last sentence "“Note “ was very encouraging.

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@npolanco

Thank you for taking the time to answer my post in detail. I have read it more than once and consider it my introduction into this new phase of our lives. The last sentence "“Note “ was very encouraging.

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Feel free to contact me as further questions arise, which they probably will.

My side effects were minimal (loose stools; slow urination), but they resolved themselves in 2 - 3 weeks. Careful targeting of the radiation, and separation of the colon from resting against the prostate, were likely the key there.

Now I just have to deal with taking Lupron (fatigue, some lethargy, weakness (noticed largely in the legs), and weight gain around the waist). One risk I'm concerned with is osteoporosis (bone fragility).

Dr. J

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A good friend was treated for prostate cancer 8 years. He had the Cyberknife radiation protocol and said it was so easy with respect to comfort or side effects that it was a non-event. His first every-six-months Lupron injection, on the other hand, left him unable to walk for a few weeks. He was not fully informed of the adverse effects and it took almost a year to fully recover full strength. Needless to say, he refused any further injections. In his case, the Lupron was thought to improve his cancer-free odds by 2%. Since his odds were estimated (for what it's worth) as under 5%, he thought the Lupron side effects weren't worth it. But everyone has a different experience and that was just his.

His PSA has remained low since the radiation and he takes no medicines.

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I was Lupron for 6 months (2 - 3 month shots) 35 radiation treatments
70 Gy. Psa 3 months after final radiation treatment was 0.00.Lupron affected first PSA test 6 months later 0.00 It has been approximately 2 years since final treatment PSA still 0.00.

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My friend's (now former) oncologist failed to inform of the problematic adverse effects from Lupron and instead blithely mentioned 'some fatigue.' Please research the adverse effects since knowledge is power. Here are two excerpts about Lupon and coronary stuff.

"What is important is that men with prostate cancer who receive either of these types of drugs are at risk for experiencing cardiovascular side effects."
https://www.health.harvard.edu/blog/cardiovascular-safety-from-prostate-cancer-drugs-remains-uncertain-202109242603
"...there's enough concern to advise men undergoing ADT to keep their cholesterol, blood sugar, and blood pressure levels low. Those with existing heart disease should be on low-dose aspirin if they can tolerate it."
https://www.webmd.com/prostate-cancer/news/20100201/heart-risk-from-prostate-cancer-hormone-therapy

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@visaliajoe

I must be unusual. I had a Gleason of 9 with not spreading. I had a Lupron shot prior to Barchy treatment. I refuse beam radiation after my first PSA was .o4. I also refused another Lupron shot. My PSA's have all been less then 1. When I refuse the beam radiation my urologist said wise move but was not as happy when I refused the second Lupron shot. But said we will wait and see. I was rushed to have the initial procedure because of my Gleason but after that no pressure. Please, remember you are in control.

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Thank you. Interesting. I had Gleason 9 psa 22. Staged 3C. Prostate too large to remove. Had radiation and then chemo (taxotere). Been on lupron for approx 1 yr. Completed radiation and then chemo 7 mos ago. They’re telling me I need to stay on lupron for life. I don’t like the effects…libido obvious but also tiredness, trouble focusing and some leg and balance issues. I still run my business and blessed with energy at 78 to fight this. They said it metastasized but not in tissue, organ, bone or lymph nodes per scans. This is also my 2nd cancer bout. Throat cancer 13 yrs ago stage 4.

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@thomaswmartin

Thank you. Interesting. I had Gleason 9 psa 22. Staged 3C. Prostate too large to remove. Had radiation and then chemo (taxotere). Been on lupron for approx 1 yr. Completed radiation and then chemo 7 mos ago. They’re telling me I need to stay on lupron for life. I don’t like the effects…libido obvious but also tiredness, trouble focusing and some leg and balance issues. I still run my business and blessed with energy at 78 to fight this. They said it metastasized but not in tissue, organ, bone or lymph nodes per scans. This is also my 2nd cancer bout. Throat cancer 13 yrs ago stage 4.

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Hi Thomas, those are tough symptoms to manage, especially the fatigue and focus isses while still running a business. Do you work at a home office where you can pace yourself and take breaks as needed?

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@thomaswmartin

Thank you. Interesting. I had Gleason 9 psa 22. Staged 3C. Prostate too large to remove. Had radiation and then chemo (taxotere). Been on lupron for approx 1 yr. Completed radiation and then chemo 7 mos ago. They’re telling me I need to stay on lupron for life. I don’t like the effects…libido obvious but also tiredness, trouble focusing and some leg and balance issues. I still run my business and blessed with energy at 78 to fight this. They said it metastasized but not in tissue, organ, bone or lymph nodes per scans. This is also my 2nd cancer bout. Throat cancer 13 yrs ago stage 4.

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After 5 years and metastases to L2 lumbar I am back on Zolodex PSA dropped from 25 to 1.2 with radiation of 1 inch off L2 and injections every 3 mos of Zolodex

Try Zolodex no side affects for me

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I was on Lupron for two-full years. Also had RP and radiation treatments. I have been off of it for over a year. I am waiting for the erections to come back. I was assured that they would once I stopped the Lupron injections.

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