Eligard - 1 mo. , 3 mo., 6 months: any difference in side effects?

I recently had an injection of Eligard (6 mo dose). For me, the injection (abdominal) was not painful at all, and I had no irritation at the injection site afterwards. Everyone's experience is different. As to Stebro's orginal question about side effects, the dosage shouldn't make any difference, as the Eligard is a time release drug that spreads the dosage out over the full time period.

I didn't have anything that showed up on the PSMAPET scan so the cancer was very small. Medicare A nd B coverd quite a bit of the cost of the Qrgovix scrip and then went through an application process and qualified for a waiver for the rest of the cost. Just finished two months ago the 6 month $27,000 treatment - 1 pill a day... I was told by my Dr that there are worthwhile reasons to go this route;
Acts quicker
Depresses testosterone to a greater degree
Less possible heart problem probability
Testosterone, more than likely, will come back sooner

I just had a pet scan. While it showed no spread to the bones there are lesions on upper lymph nodes. The doctor is suggesting Lupron every three months. If anyone has taken this injection please let me know the pros and cons. I have read of hot flashes etc and this scares me.

I am 79years old and have had stage iv prostate cancer for about three years. Part of my early treatment was Eligard shots for about a year. It's a time release shot so frequency shouldn't matter. It takes your testosterone down below 50 on the theory that the testosterone is feeding the cancer.

The shot was given in my belly and was painful. I had night sweats and hot flashes on and off, but nothing intolerable. If you had a sex life it goes to zero.

I came off it after a year or so, my testosterone slowly returned, and with it an infrequent and pale imitation of a sex life.

My psa has again been rising and my oncologist is lobbying to resume the Eligard shots. I told him I was not convinced of the inexorable relationship between high testosterone and high PSA but if my next blood work showed a steady or falling testosterone and a radically high PSA , which was the PSA trend, I would consent to resume the Eligard shots.

My next blood work showed a testosterone level which skyrocketed to my highest ever recorded level and a PSA which had a precipitous drop. I declined to proceed with the Eligard as I think my most recent blood work shows it was not my high testosterone level driving the increase in PSA but something else.

First, sorry to hear about the spread to the lymph nodes...if there's any good news, it's that there is no involvement of the bones or organs based on the scan,

Now, next question, what to do...?

More and more data indicates treating the entire PLNs system with radiation and adding ADT, six months generally though some studies indicate 12-24 months. I believe the more common approach is six months. The radiation treatment plan will call for 25 or so treatments, 45 Gya, with boosts to the identified sites and wider treatment margins around them.

As to the side affects of Lupron, yep, you can read all about them...the question is which ones will you experience and the severity. If you are familiar with statistics and the Bell Curve, question is, which ones will you experience and how "severe?"

I was on Lupron for 18 months, side affects I experienced:

Hot flashes.
Genitalia shrinkage
Fatigue, mild
Muscle and joint stiffness.

What I did not experience:

Depression
Loss of libido.

After I stopped Lupron, testosterone came back and all is "well."

You may want to discuss with your medical team an alternative to Lupron: https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-hormone-therapy-treating-advanced-prostate-cancer

It does not have the flare associated with Lupron, has a better cardiovascular side affect profile and testosterone is quicker to recover when you stop. Depending on your insurance, may be more costly.

Throughout my time on Lupron I continued exercising, travelling, more or less my normal life. Some of the more humorous things were not using the heated pool at the gym, not running the heater in the car, going out on the back deck in the dead of winter...

Given the spread to the PLNs, doing nothing may not be an option. If you and your medical team agree, then, question is what do we do...monotherapy is not necessarily the best option, doublet therapy may be a better choice in terms of a longer and more durable "remission." Note I don't say "cure" since the prevailing theory is advanced PCa is not "curable." I went with triplet therapy, adding taxotere. I did that because of the aggressive nature of my PCa. Depending on your clinical data such as doubling and velocity times, time to SRT after surgery...

Here's an article on the hot flashes. You can find more. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338189/

My general feeling is the medical community has a "just tough it out" attitude towards the side affects of ADT rather than proactively helping men mitigate them.

Similar circumstances I would wait on pet scan when and if PSA rises

39 rounds 2018 on zolodex but took me off 2 years

4 years later castrate sensitive metastatic in L2 and T12 Had radiation Stage 4 no cure but can control they say
I has L2 lumbar nuked 1 inch pc out On Zolodex to stop testosterone the fertilizer of pc
Covid shots can throw off PSA tests Wait 3 months
My PSA 1.2 for years then 4 5 6 Just had bone and ct scans Results Monday 12th

GET BACK on Zolodex injections every 3 months Forget about sex Live. Stay castrate sensitive for as long as possible Then other options like Enzalutamide a daily chemo in a pill

Currently in Eligard therapy & radiation
Only 4months into Eligard therapy and all side effects have stopped..
PSA at start 0.33.
Extreme hot flashes started 8weeks
PSA at 11 weeks .059 testosterone <10..
is this concerning?

@vjlvpjalways, at face value, your comment about side effects having subsided after 4 months of Eligard and radiation therapy. But you are concerned.

I'm moved your message to this discussion so you can connect with @stebro @rxharleydude @kujhawk1978 @russ153 @redroadtraveler, who have experience with Eligard and perhaps radiation.
- Eligard - 1 mo. , 3 mo., 6 months: any difference in side effects?: https://connect.mayoclinic.org/discussion/eligard-1-mo-3-mo-6-months-any-difference-in-side-effects/

@vjlvpjalways, what is your PSA now? What is your main concern?

On the surface none of this seems concerning. But, I have to ask - Is this your first treatment or salvage treatment? Have you had any other treatment? You don't mention surgery or radiation.
And, what was your Gleason score when you were first diagnosed?