Re: Minimising Zoledex side effects

[Guest guest]

Thank you for answering my mail. Maybe medically situations are different here, because I do not know what PSA readings, Gleason grades etc. are.

I note with interest that you say that the effects can take months to go. The surgeon here said they should go in 2 weeks, and hence after 7 we are worrying. May I ask how you know that the side effects can last that long? It means that has had up to 18 'sweats' a day for nearly 11 months, so you can imagine physically he is a wreck. I make sure he has a good diet, he takes homeopathic pills, and has been given Vit.B1 & 6.Plus of course all the medications prescribed.

Regards

[Guest guest]

PSA is about the best quick test available for telling actvity of prostate tissue. It can be raised by benign growth, infection or tumour, so at diagnosis cancer is not always the cuase of elevation.

Gleason grade is an indication of teh agressiveness of the cancer. Basically the larger the cells the less agressive - it is more complex than that,.

Your doctors should be able to tell you both figures and how PSa has progressed.

-----Original Message-----From: Newman Sent: 14 September 2004 18:20To: ProstateCancerSupport Subject: Re: Minimising Zoledex side effects

Thank you for answering my mail. Maybe medically situations are different here, because I do not know what PSA readings, Gleason grades etc. are.

I note with interest that you say that the effects can take months to go. The surgeon here said they should go in 2 weeks, and hence after 7 we are worrying. May I ask how you know that the side effects can last that long? It means that has had up to 18 'sweats' a day for nearly 11 months, so you can imagine physically he is a wreck. I make sure he has a good diet, he takes homeopathic pills, and has been given Vit.B1 & 6.Plus of course all the medications prescribed.

Regards

[Guest guest]

I am probably being dumb here. Each time prior to going to have the shot, and twice since he stopped 7 weeks ago, he has had a series of blood tests. We know that the Cancer is contained, although is no longer on hormonal therapy medication.

I am looking at 4 pages of results from 13.09 as I write this. I see nothing that refers to PSA etc. However the Testosterone count is 2.0 pmol/l (French) normal it says is 49.0 - 145.0. How does that work out in comparison with U.K. counts?

[Guest guest]

Hi ,

If you were to ask your surgeon, I'm pretty sure he would give you the readings.

Here, plucked out of the hat to give you a quick response, is an abstract which mentions T recovery time. There will be more up to date ones, and if you wish I will be happy to provide more evidence in a day or two.

"The first two treatment cycles lasted 73 and 75 weeks,"........."Serum testosterone returned to the normal range within 8 weeks (range, 1 to 26) of stopping treatment." In other words, the men were on Zoladex or similar for a year and a bit, and the effects wore off anywhere between 1 week and 26 weeks after stopping it. Perhaps some of the group could chime in with their T recovery experiences.

.

Urology. 1995 May;45(5):839-44; discussion 844-5. Intermittent androgen suppression in the treatment of prostate cancer: a preliminary report.Goldenberg SL, Bruchovsky N, Gleave ME, Sullivan LD, Akakura K.Department of Surgery, University of British Columbia, Vancouver, Canada.OBJECTIVES. To test the feasibility of using intermittent androgen suppression in the treatment of prostate cancer by taking advantage of the reversible action of medical castration. METHODS. Observations were made on a group of 47 patients (clinical Stage D2, 14; D1, 10; C, 19; B2, 2; and A2, 2) with a mean follow-up time of 125 weeks. Treatment was initiated with combined androgen blockade and continued for at least 6 months until a serum prostate-specific antigen (PSA) nadir was observed. Medication was then withheld until the serum PSA increased to a mean value between 10 and 20 ng/mL. This cycle of treatment and no treatment was repeated until the regulation of serum PSA became androgen independent. RESULTS. The first two treatment cycles lasted 73 and 75 weeks, with a mean time off therapy of 30 and 33 weeks and an overall mean percentage time off therapy of 41% and 45%, respectively. The mean time to achieve a nadir level of serum PSA was 20 weeks in cycle 1 and 18 weeks in cycle 2. Serum testosterone returned to the normal range within 8 weeks (range, 1 to 26) of stopping treatment. The off-treatment period in both cycles was associated with an improvement in sense of well-being and the recovery of libido and potency in the men who reported normal or near-normal sexual function before the start of therapy. In 7 patients with Stage D2 disease, the cancer progressed to an androgen-independent state. The mean and median times to progression were 128 weeks and 108 weeks, respectively. Seven patients have died, 1 from a noncancer-related illness, with mean and median overall survival times of 210 weeks and 166 weeks, respectively. CONCLUSIONS. Prostate cancer is amenable to control by intermittent androgen suppression. This approach affords an improved quality of life when the patient is off therapy. It also results in reduced toxicity and cost of treatment and possibly delays tumor progression. Whether survival is affected in a beneficial or adverse way remains to be studied in a randomized, prospective study.PMID: 7538246

-----Original Message-----From: Newman Sent: Tuesday, September 14, 2004 6:20 PMTo: ProstateCancerSupport Subject: Re: Minimising Zoledex side effects

Thank you for answering my mail. Maybe medically situations are different here, because I do not know what PSA readings, Gleason grades etc. are.

I note with interest that you say that the effects can take months to go. The surgeon here said they should go in 2 weeks, and hence after 7 we are worrying. May I ask how you know that the side effects can last that long? It means that has had up to 18 'sweats' a day for nearly 11 months, so you can imagine physically he is a wreck. I make sure he has a good diet, he takes homeopathic pills, and has been given Vit.B1 & 6.Plus of course all the medications prescribed.

Regards

[Guest guest]

,

's T at 2.0 pmol/L is still castrate or as good as. We in the UK use nmol/L to record T levels, and in the US ng/dl is commonly used. It is easy to convert UK to US and vice versa, but I am not familiar with the conversion to pmol/L. Perhaps someone who is better at sums than I am can convert for you. There may not be a direct conversion, but someone may come up with a usable approximation.

.

(A nanomol - nmol - is 10 to the minus 9 mol.

A picomol -pmol - is 10 to the minus 12 mol.)

-----Original Message-----From: Newman Sent: Tuesday, September 14, 2004 7:10 PMTo: ProstateCancerSupport Subject: Re: Minimising Zoledex side effects

I am probably being dumb here. Each time prior to going to have the shot, and twice since he stopped 7 weeks ago, he has had a series of blood tests. We know that the Cancer is contained, although is no longer on hormonal therapy medication.

I am looking at 4 pages of results from 13.09 as I write this. I see nothing that refers to PSA etc. However the Testosterone count is 2.0 pmol/l (French) normal it says is 49.0 - 145.0. How does that work out in comparison with U.K. counts?

[Guest guest]

, am I to presume that this T is a fair result?

However, it does not help us on the side effects. I find it intringuing that a qualified well established Surgeon here,says the effects should be over in 2 weeks, and that he has never experienced someone to have them 7 weeks after the 3 monthly period is over. Maybe we should not comment?

This is really why I found your Support group, to try and find out WHY?

[Guest guest]

,

Unless you have a T level taken prior to starting Zoladex, you can't of course tell how far it has dropped since starting, or get a feel for how it might recover. It is very common for men not to have their T level checked before starting Zoladex or similar. Despite not being familiar with the units used, if the object of the exercise was to get T to a castrate level then the desired result has been achieved.

Can't comment on the surgeon's experiences, except to say that he is incorrect (or was misunderstood? (sorry)) if he said that the side effects (which relate to the level of T) would be gone in a fortnight after not having had a due jab. It's a case of waiting to see when and how far T will recover.

.

-----Original Message-----From: Newman Sent: Tuesday, September 14, 2004 7:51 PMTo: ProstateCancerSupport Subject: Re: Minimising Zoledex side effects

, am I to presume that this T is a fair result?

However, it does not help us on the side effects. I find it intringuing that a qualified well established Surgeon here,says the effects should be over in 2 weeks, and that he has never experienced someone to have them 7 weeks after the 3 monthly period is over. Maybe we should not comment?

This is really why I found your Support group, to try and find out WHY?

[Guest guest]

Hi ,

I was on Zoladex, Casodex and Proscar (combined hormone treatment) for 18 months. I then stopped the treatment to try intermittent hormone therapy. It took 6 months for my testosterone to begin to rise and well over a year for it to get back to normal.

is obviously having a bad time and needed to come off them to slow the side effects. And I wish him well but it may take time. To show that hormone treatment has such widely different reactions my experience is completely opposite. The age difference may play a part. I'm 57. I apologise but I must put the counter argument so that we don't frighten everyone off using hormone treatment. I'll do that in a separate email.

RE: Minimising Zoledex side effects

Hi ,

If you were to ask your surgeon, I'm pretty sure he would give you the readings.

Here, plucked out of the hat to give you a quick response, is an abstract which mentions T recovery time. There will be more up to date ones, and if you wish I will be happy to provide more evidence in a day or two.

"The first two treatment cycles lasted 73 and 75 weeks,"........."Serum testosterone returned to the normal range within 8 weeks (range, 1 to 26) of stopping treatment." In other words, the men were on Zoladex or similar for a year and a bit, and the effects wore off anywhere between 1 week and 26 weeks after stopping it. Perhaps some of the group could chime in with their T recovery experiences.

.

Urology. 1995 May;45(5):839-44; discussion 844-5. Intermittent androgen suppression in the treatment of prostate cancer: a preliminary report.Goldenberg SL, Bruchovsky N, Gleave ME, Sullivan LD, Akakura K.Department of Surgery, University of British Columbia, Vancouver, Canada.OBJECTIVES. To test the feasibility of using intermittent androgen suppression in the treatment of prostate cancer by taking advantage of the reversible action of medical castration. METHODS. Observations were made on a group of 47 patients (clinical Stage D2, 14; D1, 10; C, 19; B2, 2; and A2, 2) with a mean follow-up time of 125 weeks. Treatment was initiated with combined androgen blockade and continued for at least 6 months until a serum prostate-specific antigen (PSA) nadir was observed. Medication was then withheld until the serum PSA increased to a mean value between 10 and 20 ng/mL. This cycle of treatment and no treatment was repeated until the regulation of serum PSA became androgen independent. RESULTS. The first two treatment cycles lasted 73 and 75 weeks, with a mean time off therapy of 30 and 33 weeks and an overall mean percentage time off therapy of 41% and 45%, respectively. The mean time to achieve a nadir level of serum PSA was 20 weeks in cycle 1 and 18 weeks in cycle 2. Serum testosterone returned to the normal range within 8 weeks (range, 1 to 26) of stopping treatment. The off-treatment period in both cycles was associated with an improvement in sense of well-being and the recovery of libido and potency in the men who reported normal or near-normal sexual function before the start of therapy. In 7 patients with Stage D2 disease, the cancer progressed to an androgen-independent state. The mean and median times to progression were 128 weeks and 108 weeks, respectively. Seven patients have died, 1 from a noncancer-related illness, with mean and median overall survival times of 210 weeks and 166 weeks, respectively. CONCLUSIONS. Prostate cancer is amenable to control by intermittent androgen suppression. This approach affords an improved quality of life when the patient is off therapy. It also results in reduced toxicity and cost of treatment and possibly delays tumor progression. Whether survival is affected in a beneficial or adverse way remains to be studied in a randomized, prospective study.PMID: 7538246

-----Original Message-----From: Newman Sent: Tuesday, September 14, 2004 6:20 PMTo: ProstateCancerSupport Subject: Re: Minimising Zoledex side effects

Thank you for answering my mail. Maybe medically situations are different here, because I do not know what PSA readings, Gleason grades etc. are.

I note with interest that you say that the effects can take months to go. The surgeon here said they should go in 2 weeks, and hence after 7 we are worrying. May I ask how you know that the side effects can last that long? It means that has had up to 18 'sweats' a day for nearly 11 months, so you can imagine physically he is a wreck. I make sure he has a good diet, he takes homeopathic pills, and has been given Vit.B1 & 6.Plus of course all the medications prescribed.

Regards