Can Lupron dosage be lowered to cut down on side effects?

Posted by seabiscuit @seabiscuit, Dec 19, 2021

Stared taking lupron shots after radiation failed. My psa hit 10 . After first month my psa dropped to 5 . The second month it dropped to .5. After radiation my PSA never went lower than 1.25. So I am happy with results but tired of side effects. My question is can they adjust the Lupron dosage a little to cut down on side effects.

Interested in more discussions like this? Go to the Prostate Cancer group.

@seabiscuit I wonder if the information in this link may be helpful?

– Lupron Dosing & Administration:
https://www.lupronpedpro.com/dosing-and-administration.html
Have you asked your oncologist if a custom dose would be an option to test a reduction in side effects?

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Not a medical person so just my thoughts and perspective.

The objective behind taking Lupron is to shut down the production of testosterone from your testicles, getting your T level below 50, ideally 20. That shuts off the "fuel" which feeds prostate cancer.

It is this level of testosterone that results in the side affects we know so well – hot flashes, fatigue, genitalia shrinkage, loss of libido (80% of men do, I was in the 20% group, sigh…), muscle and joint stiffness, CV, metabolic and for some, cognitive and emotional issues.

So, not sure that adjusting the dosage changes the root cause of the side affects, castrate level of testosterone!

I did 18 months of Lupron, experienced all the side affects except the emotional. I did mitigate those side affects though through diet and exercise. The latter was not easy given the fatigue and muscle and joint stiffness.

There are other options which may to a degree have "lesser" side affects but they still zero out the testosterone which…
https://pubmed.ncbi.nlm.nih.gov/12686820/
https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-hormone-therapy-treating-advanced-prostate-cancer
Kevin

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@kujhawk1978

Not a medical person so just my thoughts and perspective.

The objective behind taking Lupron is to shut down the production of testosterone from your testicles, getting your T level below 50, ideally 20. That shuts off the "fuel" which feeds prostate cancer.

It is this level of testosterone that results in the side affects we know so well – hot flashes, fatigue, genitalia shrinkage, loss of libido (80% of men do, I was in the 20% group, sigh…), muscle and joint stiffness, CV, metabolic and for some, cognitive and emotional issues.

So, not sure that adjusting the dosage changes the root cause of the side affects, castrate level of testosterone!

I did 18 months of Lupron, experienced all the side affects except the emotional. I did mitigate those side affects though through diet and exercise. The latter was not easy given the fatigue and muscle and joint stiffness.

There are other options which may to a degree have "lesser" side affects but they still zero out the testosterone which…
https://pubmed.ncbi.nlm.nih.gov/12686820/
https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-hormone-therapy-treating-advanced-prostate-cancer
Kevin

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Thanks Kevin. I have always had a low tolerance for medicine. And thru the years i found that cutting the prescription back gave me more of a desired effect rather than overkill with meds. Although this is my first with this kinda medicine. Dr prescribed me colestipol for diarhea years ago. He said take 1 pill 2 times a day. i couldnt go for a week. i started cutting pill in half. i got it down to 1/8 pill which stopped diarhea without constipation. however now i have constipation. i was told to take 1 teaspoon of this laxative. I take 1/8 teaspoon. works good for me. Just saying to me not one pill or treatment fits all. These were just a few examples, I have many more. I have learned something here . Appears to me this treatment is not a cure just a temporary set back for the cancer cells.

Thing thats gets me I was taking testosterone shots for low testosterone when i got cancer. Thats another story.

Thanks for your reply

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@seabiscuit

Thanks Kevin. I have always had a low tolerance for medicine. And thru the years i found that cutting the prescription back gave me more of a desired effect rather than overkill with meds. Although this is my first with this kinda medicine. Dr prescribed me colestipol for diarhea years ago. He said take 1 pill 2 times a day. i couldnt go for a week. i started cutting pill in half. i got it down to 1/8 pill which stopped diarhea without constipation. however now i have constipation. i was told to take 1 teaspoon of this laxative. I take 1/8 teaspoon. works good for me. Just saying to me not one pill or treatment fits all. These were just a few examples, I have many more. I have learned something here . Appears to me this treatment is not a cure just a temporary set back for the cancer cells.

Thing thats gets me I was taking testosterone shots for low testosterone when i got cancer. Thats another story.

Thanks for your reply

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Lupron is a suppressor, it does not kill prostate cancer cells like chemotherapy nor remove them like surgery does.

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I took Lupron for 25 months. Now, two years after stopping it, my testosterone is about 15 and I cannot get it higher. I tried a testosterone replacement with my breath started to develop. I wish I would have terminated Lupron at 18 months when I told the doctor I had enough but he insisted I continue with it. Today I am always very fatigued.

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@hergiew

I took Lupron for 25 months. Now, two years after stopping it, my testosterone is about 15 and I cannot get it higher. I tried a testosterone replacement with my breath started to develop. I wish I would have terminated Lupron at 18 months when I told the doctor I had enough but he insisted I continue with it. Today I am always very fatigued.

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I mean breasts, not breath.

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@seabiscuit

Thanks Kevin. I have always had a low tolerance for medicine. And thru the years i found that cutting the prescription back gave me more of a desired effect rather than overkill with meds. Although this is my first with this kinda medicine. Dr prescribed me colestipol for diarhea years ago. He said take 1 pill 2 times a day. i couldnt go for a week. i started cutting pill in half. i got it down to 1/8 pill which stopped diarhea without constipation. however now i have constipation. i was told to take 1 teaspoon of this laxative. I take 1/8 teaspoon. works good for me. Just saying to me not one pill or treatment fits all. These were just a few examples, I have many more. I have learned something here . Appears to me this treatment is not a cure just a temporary set back for the cancer cells.

Thing thats gets me I was taking testosterone shots for low testosterone when i got cancer. Thats another story.

Thanks for your reply

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I was diagnosed with Prostate Cancer 2 years ago .. only had 1 shot of Lupron .. then 20 radiation treatments.. that knock my PSA down below 0.5..for a year or so.. The mind is the most important sex organ.. at 84 it has been a wonderful life.. and its still going strong..

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Thanks for all your comments.

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I have a question….if hormone therapy only suppresses the growth of cancer cells, why isn't surgery to remove the cancer a more practical approach?

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@kujhawk1978 and others concerning Lupron dosage.. There are articles (very complicated terms are used .. but your physician can help with those when given a copy…) The Body Mass Index (BMI) … how "heavy, fat, obese" you are can affect how effective the Lupron dosage is .. The dosage is most often given without reference to BMI. https://clincancerres.aacrjournals.org/content/13/13/4027.short

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@gregorylynn

I have a question….if hormone therapy only suppresses the growth of cancer cells, why isn't surgery to remove the cancer a more practical approach?

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Gregory, good question. Deciding which treatment is best is a very individual choice. Hormone therapy may also be called androgen suppression therapy. "Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.

Hormone therapy may be used:
– If the cancer has spread too far to be cured by surgery or radiation, or if you can’t have these treatments for some other reason
– If the cancer remains or comes back after treatment with surgery or radiation therapy
– Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level, and/or growth of the cancer outside the prostate)
– Before radiation to try to shrink the cancer to make treatment more effective"

Read more: https://www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html

If I recall correctly, your first treatment was radiation and more recently you received the news that the cancer has returned. Often surgery alone is not possible with metastatic cancer because it is not localized to one specific tumor or area, like the prostate. What treatments are you getting?

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@colleenyoung

Gregory, good question. Deciding which treatment is best is a very individual choice. Hormone therapy may also be called androgen suppression therapy. "Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.

Hormone therapy may be used:
– If the cancer has spread too far to be cured by surgery or radiation, or if you can’t have these treatments for some other reason
– If the cancer remains or comes back after treatment with surgery or radiation therapy
– Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level, and/or growth of the cancer outside the prostate)
– Before radiation to try to shrink the cancer to make treatment more effective"

Read more: https://www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html

If I recall correctly, your first treatment was radiation and more recently you received the news that the cancer has returned. Often surgery alone is not possible with metastatic cancer because it is not localized to one specific tumor or area, like the prostate. What treatments are you getting?

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I just finished my PET scan and the good news is that there is only 1 spot of cancer, in my scapula. I also started hormone therapy. I trust my doctors and Mayo. I feel they are the best at what they do. And I appreciate the whole team. When I was referred to Mayo by my home doctor, I met with an orthopedic surgeon. I recall a comment he made about the possibility of replacing the scapula or cutting out the cancerous growth and filling the void with bone cement. So, that is where my question comes from. When reading the other posts, it just keeps coming to mind. Radiation treatments start next month. It has only been about 5 days, but already I am having discomfort. A good thing for me is that with each passing day, I am not as emotional as when I first got the news. Now I feel like I am ready to fight no matter what it takes.

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