Lupron Treatment Duration: How long were you on it?

Posted by frankstags @frankstags, Jul 7 10:28am

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.

My treatment plan and related side-effects from Lupron are almost identical. I completed radiation treatment in May and plan to have my PSA tested in September. I remain on Lupron until then. My goal is to stop Lupron in September, presuming my PSA levels have dropped to a low and acceptable level. I will then be re-tested approximately 3 months later to determine if there has been any change in my PSA. Frankly, I don't believe there is a standard protocol for the duration of Lupron based on MD conversations and my own research. It has become apparent to me that some MDs will err on the side of long duration, even as long as two years to make sure that any remaining or emergent cancer cells post-radiation are starved of all testosterone to prohibit growth. Of course, extended use of Lupron guarantees that you will continue to suffer side-effects for some time, the most difficult of which in my judgment is the loss of libido. After two years on Lupron, regaining your libido after cessation of hormone treatment is highly problematic. Moreover, Lupron also can contribute to longer term health problems, including coronary issues. Much depends on the health on the individual patient. As always with prostate cancer it seems, hormone deprivation therapy comes with its own series of trade-offs that make clearcut decisions difficult. I would bring your hard questions to your urologist when you meet with him on this topic.

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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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Why did you not elect the prostatectomy surgical option?

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After consulting several urologists, I concluded that based on my age (73), Gleeson scores, confinement of my cancer within the prostate capsule, and the relative post-treatment side-effects of both options, that radiation was the best choice for me. I went back and forth on deciding between oth options. The tipping point was a conversation with a Mayo urologist and surgeon who put it this way (I'm paraphrasing.), "My father is your age. Either surgery or radiation is a good choice to attack the cancer. However, the possible complications from surgery — ED, incontinence, etc. — are more consequential in the near term and can contribute negatively to your lifestyle. Radiation consequences are apt to more consequential in the longer term. At 73 or older, there's a good statistical likelihood that another disease or medical malady is going to enter your life in the not too far distant future. Do you want to suffer with surgical post-effects from prostate removal only to be hit from the side by another medical dilemma? Why suffer more than you need to." Put simply, for me it was a trade off between "pay now or pay later." I chose the former. Your calculus may be different, keeping in mind that the long term survivability rates for both treatments are effectively the same.

Liked by dandl48 Dave

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@horace1818

Why did you not elect the prostatectomy surgical option?

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Urologist ruled out due to my weight.

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@frankstags

Urologist ruled out due to my weight.

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That makes sense. I had the same numbers as you and had the surgery 4 years ago at 74. PSA now still below detectable level. Some adverse effects from surgery but not serious. Best of luck with your therapy.

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Thanks to all

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@frankstags

Urologist ruled out due to my weight.

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good morning i too struggle with my weight but luckily i was able to get the surgery done good luck to you ps i,m also 58 yrs old

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@john57

good morning i too struggle with my weight but luckily i was able to get the surgery done good luck to you ps i,m also 58 yrs old

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Hi John. I'm curious to know how long you anticipate being on Lupron. I had my surgery in May of 2019, and I've heard from doctors to stay on Lupron anywhere from 18 to 36 months. I'm 59 years old.

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hi mr buuck i had my surgery on 10/2/19 so far i had 2 lupron shots and luckily my psa was 0.2 which is very good i,m not sure how much longer i have to get these shots. my side effects are fatigue and at night time i,m cold

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@semeon

I have been on Lupron for 2 years and recently had another 6 month injection. All symptoms mentioned I have. I was jus wondering any idea how long a person needs to be on Lupron?

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Great question and one that I ask frequently. That said, I get mixed answers from MDs. My suspicion is that most take the "better safe than sorry" approach. Apart from the side effects (far from insignificant in my opinion), there is no doubt that lupron suppresses testosterone which feeds cancer cells. But if cancer is no longer present, why is lupron still needed? After 2 years and now an additional 6 months in your case, I wonder what the risk is by discontinuing lupron? My hunch is that the data is inconclusive. If there is good data, then your physician should be able to share it with you. While there is always risk, what's the percentage? Ultimately you should decide if the risk is worth taking. One major concern with an extended lupron treatment, as in your case, is whether your libido will ever return. The evidence suggests that it won't after extended ADG therapy — or won't to a significant degree. While this may not be a concern for you, it can be a concern for many.

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I have been on Lupron for 2 years and recently had another 6 month injection. All symptoms mentioned I have. I was jus wondering any idea how long a person needs to be on Lupron?

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@semeon

I have been on Lupron for 2 years and recently had another 6 month injection. All symptoms mentioned I have. I was jus wondering any idea how long a person needs to be on Lupron?

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@semeon, I moved your question to the discussion where @frankstags asked the same thing "Lupron Treatment Duration: How long were you on it?" Click VIEW & REPLY to see responses from @bruto1 @dmadi61 @jonbuuck and others. Has your oncologist given an indication how long you'll be on it or what measurements would be used to determine when you can stop?

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After receiving input from this message board, I contacted my doctor and asked him the same question. I received two injections in Feb and May and was scheduled to received another one in August. He agreed to wait until receiving my first post radiation therapy PSA test to discuss further. This will be in the Oct-Nov time frame. At least it will spread me out to a 6 month interval if he feels I need another one. Again, it appears there is no consistent methodology for
determining how many shots are needed.

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Glad you asked! Thanks for sharing. And, yes, as I observed in an earlier response, there appears to no "consistent methodology" for determine the length of Lupron treatment post-radiation and/or surgery if originally indicated. Depending upon the individual, the "cure" may be worse than the disease according to your lifestyle requirements and your age.

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