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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@vjlvpjalways

They continue Lupron after hormone resistance?

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My understanding is that the cancer becomes active again while getting Lupron because it has developed ways of producing its own testosterone and is less dependent on the testosterone made by the body. Lupron, however, still slows cancer growth to some degree. This is probably an oversimplification but, as a layman, it’s the best I have.

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Had my third Lupron yesterday to treat my Gleason 8 PC. PSA after the first two doses was undetectable! Great news. Prior to taking round three I spoke with two urologist and both reported two years/ four injections was standard but considering my quality of life issues I could discontinue if I wanted. (Joint pain, weight gain, flacid, fatigue.) However they both responded that the side effects would not go away. Not sure what I would have gained by stopping treatment. One doctor told me two years on Lupron would probably increase my life expectancy by "a few years. The other told me the goal was to increase life expectancy by 10+ years. So I guess we just keep yaking it and live with the side effects.

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@dmadi61

Hi Frank, My diagnosis was almost exactly the same as yours. Stage 3. Gleason 7 (4+3). PSA was 16. I had high dose Brachytherapy followed by 25 rounds of external beam therapy. I was on Lupron for 2 full years. A shot every 3 months. My last injection was January 30, 2020. I was treated at Moffitt Cancer Center in Tampa and considered a high risk patient. I had all my labs tested every 3 months. Lupron is effective but I hated the side effects. I went to the gym and / or walked as most days. Took lose dose Paxil for the hot flashes - worked well. Did crossword puzzles everyday to try to clear the mental fog. I also was given the book "Androgen Deprivation Therapy" by Richard J. Wassersug PhD which has great info. Feel free to reach out to me with any questions. Hope I can help.

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i am at the 15 month mark, so far the side effects have not really bothered me, yeah there is the little wrap around the middle but as long as I am really conscious of the rest of my body weight it seems like keeping that under control works, the little spare around the middle its more of a nuisance . I do not care about libido at age 76 I am very strong, cyclist , xc skier that is more important than sex at least for me . It was always a mess anyway. So at least I am looking to move on to 24 months than see what happens. Keep track of the PSA always .

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I am 70, had my annual physical 7 weeks ago, my PSA had spiked to 6.9 from 4.3. I had the Biopsy, it was cancer and my Gleason was an 8. I had the Cat Scan done and the Bone Scan and no spreading. The Urologist used the term "On the Margin" like sticking to the outside of the basketball. I had my first Lupron jab and I don't like it but if he shuts down the cancer for now, that is good. I am going to have the little bas-ard taken out in 33 days now.
I don't know what Stage this is though. I have had so much sex in my life, it is no big deal but I would like to live a lot longer. I am sure I will get blasted with radiation like a lot I know and it is everyday for 4 months. Do you all know that when they cut through the prostate , cancer inevitably will escape out so I bet I will be on Lupron for some time and kill the little mfers. I think the tell is when they take it out along with two lymph nodes, what these disclose will let me know if I am long or short in this world. Will never be Chemo, it poisons your body and is just not worth it. God be with all of you. Dave

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I was on Lupron and Erleada for 13 months and RP in 6 th month. The meds were noticed and not liked but they were manageable and I think that they helped me. It was my UCLA doctors recommendation and I would do it again. If the PC returns I probably will do it again at that time.

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@scullrower

My understanding is that the cancer becomes active again while getting Lupron because it has developed ways of producing its own testosterone and is less dependent on the testosterone made by the body. Lupron, however, still slows cancer growth to some degree. This is probably an oversimplification but, as a layman, it’s the best I have.

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If your doctor knows their stuff, you should get a three-week dose of Casodex (generic Bicalutamide) when you get your first shot. Yes, Lupron or Eligard tends to increase your testosterone when first taken before lowering it. The Casodex pill, taken daily, is an immediate ADT which counteracts this tendency. When I got the Eligard/Bicalutamide combo last December, I was confused by this dichotomy, but the doctor explained it to me pretty much as I noted above.

In my case, the Eligard shot was used to make sure that the cancer wouldn't spread before I started radiation. Further tests (CT scan, bone scan, MRI) showed that the cancer had not spread beyond the prostate, so no further ADT is required.

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This one had me thinkin' (and that's never a good thing)...
I wasn't aware of Eligard, but, between the diagnosis and treatment decision, nothing was done at all. If my doc had said, "while we're figuring this out, we're gonna give you Lupron to help to start the process of starving what cancer you have" I think that would've made sense?

Anybody have any idea why that isn't done? Does it help the diagnostic processes if you leave well enough alone while imaging?
Just curious.

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@web265

This one had me thinkin' (and that's never a good thing)...
I wasn't aware of Eligard, but, between the diagnosis and treatment decision, nothing was done at all. If my doc had said, "while we're figuring this out, we're gonna give you Lupron to help to start the process of starving what cancer you have" I think that would've made sense?

Anybody have any idea why that isn't done? Does it help the diagnostic processes if you leave well enough alone while imaging?
Just curious.

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I believe that ADT will reduce PSA and impact PSMA PET scan if started prior to scan.

ADT Orgovyx initiated Jan 6 while simulation calculations for salvage radiation being computed/mapped.
Rad Onc discontinued Orgovyx 7 days later because mapping "failed" and he wanted a repeat PSMA PET scan (1st performed 6 mos prior and before RP).
Testosterone reduced from 437 prior to 41 after only 7 days.
Waited 1 month for repeat PSMA PET (no change from 1st scan); re-started Orgovyx next day; new simulation w/ balloon (joy to the world); and salvage IMRT a month later.

Not sure this is helpful; point being that ADT can skew PSMA PET scan results (I think).

Happy 4th of July to everyone. May we all enjoy today and many more.

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@michaelcharles

I believe that ADT will reduce PSA and impact PSMA PET scan if started prior to scan.

ADT Orgovyx initiated Jan 6 while simulation calculations for salvage radiation being computed/mapped.
Rad Onc discontinued Orgovyx 7 days later because mapping "failed" and he wanted a repeat PSMA PET scan (1st performed 6 mos prior and before RP).
Testosterone reduced from 437 prior to 41 after only 7 days.
Waited 1 month for repeat PSMA PET (no change from 1st scan); re-started Orgovyx next day; new simulation w/ balloon (joy to the world); and salvage IMRT a month later.

Not sure this is helpful; point being that ADT can skew PSMA PET scan results (I think).

Happy 4th of July to everyone. May we all enjoy today and many more.

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Thanks, that's what I was eluding to but hadn't had any confirmation. Makes sense!

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@web265

This one had me thinkin' (and that's never a good thing)...
I wasn't aware of Eligard, but, between the diagnosis and treatment decision, nothing was done at all. If my doc had said, "while we're figuring this out, we're gonna give you Lupron to help to start the process of starving what cancer you have" I think that would've made sense?

Anybody have any idea why that isn't done? Does it help the diagnostic processes if you leave well enough alone while imaging?
Just curious.

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Eligard, according to my HCP, is a "newer" form of Lupron. Pretty much the same chemically, if I recall, but better received by the patient. Given my lack of most of the nasties I'd read about with Lupron, I can't disagree.

As to why an ADT was not suggested to you, I can only guess that your case was different than mine. My biopsy showed cancer in 75% of the cores on the left side, and there is a definite history of PC on my dad's side. Because of that, I was deemed "intermediate unfavorable" on my diagnosis, although my PSA was under 10 and my Gleasons were mostly 3+3 with a few 3+4s. So, the full treatment (ADT, HDR, LDR) was suggested, and it apparently has worked so far.

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