Expensive meds needed after proton beam therapy for prostate cancer?

They may assign androgen-deprivation therapy for a few months or longer, depending on the situation: the most-common brands are Orgovyx (daily pill), Lupron (injection every 3 months), and Firmagon (injection every month). They're not expensive here in Canada (about US $235/month if one doesn't have any coverage), but they seem to cost much more down there in the U.S.. Do you have any other way to defer costs? I don't understand U.S. insurance, but most insurers should support at least one type of ADT.

Hi mectec and welcome to MCC.
To provide better answeres to your question, it woud be helpful to know what the results of your mri, biopsy and PSMA scan are including the Gleason score, number of cores positive for cancer and any additional features such as cribform, intraductal, seminal vesicle invasion, etc. This information is what the radiation or genitourinary oncologist would look at to determine what, if any, ADT medications to recommend.

If you do need ADT, the quarterly lupron shots administered in the doctor's office are probably covered by insurance and less expensive than the newer daily pills that you take at home, Orgovyx (relugolix), which might not be covered. If you have a higher risk/more agressive cancer, you might also be put on abiraterone which can be purchased for around $100 to $150/month without insurance by going to one of the discount online pharmacies or using coupons like GoodRx.

If you post more detailed information from your biopsy, others will be able to provide you with details from their own experiences with a similar diagnosis and using private insurance in the US.
Bill

@mectec
Are you scheduled to have proton radiation therapy or doing it?

If you are under the care of urologist and/or R/O you probably have gone through biopsies and gotten your Gleason Score. And hopefully additional test if appropriate like PSMA and Decipher.

Your urologist and/or R/O would have gone over if you were going to need it or they were going to recommend hormone treatments. Not all of us get them depending on the risk level of your prostate cancer. So, you asked about medications, and you should know if hormone treatments are part of your treatments.

Other medications: Depending on what your side effects are there are many medications to help with those. The hormone treatments can be expensive, other medications to help with urinary side effects, digestive issues, etc. are not expensive and many are OTC.

Like another poster posted if you could give more information about being scheduled for hormone treatment or not, your risk level, decipher score, low dose/high dose proton radiation treatment could probably help you more with our experience with medication costs.

There are no drugs specific to proton beam radiation that you’ll need. If your diagnosis requires hormone therapy (ADT), that will be defined as part of your treatments. (There shouldn’t be any surprises.)

Also note that ADT injectionable drugs (Lupron, Eligard, Prostap, Camcevi, Zoladex, Trelstar, Pamorelin, Decapeptyl, and Firmagon) which often are used in conjunction with external radiation, are all covered under Medicare Part B, not under Medicare Part D so, those won’t be a problem if you don’t have Part D now.

Sometimes they’ll start you with Casodex (Bicalutimude) before an ADT injection (with the exception of Firmagon). Since Casodex is a pill (not an injection), it’s not covered by Part B. You can probably find it at a very low price on GoodRx.

Without knowing the details of your diagnosis (PSA, MRI results, biopsy results, PET scan results, etc.) , there’s no way to know for sure what you might expect.

(I had 28 sessions of proton radiation (during April-May 2021), with SpaceOAR Vue, and 6 months Eligard. Those were all part of my treatments and known in advance; there were no additional drugs needed after treatment. I did start with Casodex - those cost me $12.)

Good luck,