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Re: Re: Lupron newbie

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Rip --

I've never heard of the six month protocol your doctor apparently intends to

use. There are protocols in which eight months or twelve months of

continuous androgen deprivation is followed by an off-period, but these

protocols depend on the patient reaching certain parameters. The

intermittent androgen deprivation regimen described in the Primer calls for

the use of three agents, not just one, and indicates that testosterone

should be castrate at less than 20 ng/dl and PSA undetectable at 0.05 or

less for twelve months, at which time the LHRH agonist (most commonly Lupron

or Zoladex) and the anti-androgen (Casodex or Eulexin) are discontinued.

The patient remains on the third agent (Proscar or Avodart) during the

off-phase until the testosterone levels resurge, the PSA rises to the target

level pre-determined by the doctor and patient, and then the full treatment

with the three agents is resumed.

I think you have serious need of further self-education and need to have

some serious discussion with your doctor on what protocol is likely to

benefit you the most.

Side effects of various types develop for each patient at various times and

some never develop at all. But now that you know what they are, if you

develop them you'll be aware that this is standard for the therapy you're

on.

Donna Pogliano

Co-author of " A Primer on Prostate Cancer, The Empowered Patient's Guide "

Lupron newbie

>

>

> Hi Group

> Just had my first dose of Lupron and thought I would join the group to

> find out what to expect that my Doc didn't want to mention. Brief

> history: I am 63, had a rad prost. in 92, had a rising psa in 93,

> had radiation in 93, then a rising psa in 98 (very low but doubling

> every four months), psa got to 2 in 00, then fell back to 1 over the

> next three years, then started up a year ago and went from 1.8 to 4.2

> from May to Aug. Had my first 3 mo dose of Lupron yesterday and will

> have another in Dec then cycle off and on.

> Would appreciate any comments on what to expect in way of side

effects.

> Thanks

> Rip

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Donna said: The intermittent androgen deprivation regimen described in

the Primer calls for the use of three agents, not just one,

I am curious. I am hearing more and more of men who are being prescribed

just one agent rather than 2 or 3. This is happening with men being

treated at centers of excellence and some of them have been switched

from two or three agents to one. I am sure this is not just to save $ or

to no longer line the pockets of the pharmas but I do not know the logic

to this apparent switch in hormone therapy. Does anyone know the

clinical reason for this?

Kathy

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This is what I thought the logic might be. The dates your doctor

switched correspond to the dates I started hearing more men going on a

single agent.

I think there might be a concern about side effects also but that is not

grounded in any solid information.

Kathy

Re: Lupron newbie

Kathy

My Doc is very well respected in the med community and has been my Doc

for 12 years now. I am a newbie to the use of Lupron, not to PCa.

His comment when I inquired about the cassodex was that he wanted to

keep it in reserve (He knows my ins would cover it). That there is some

indication now that it does not perform what it is reputed to. This is a

new approach for him in the last year or two. Prior it was

to use two drugs in combination. Please do not pick at my words as

they are as precise as I can recall.

Rip

>

> Donna said: The intermittent androgen deprivation regimen described in

> the Primer calls for the use of three agents, not just one,

>

> I am curious. I am hearing more and more of men who are being

> prescribed just one agent rather than 2 or 3. This is happening with

> men being treated at centers of excellence and some of them have been

> switched from two or three agents to one. I am sure this is not just

> to save $ or to no longer line the pockets of the pharmas but I do not

> know the logic to this apparent switch in hormone therapy. Does anyone

> know the clinical reason for this?

>

> Kathy

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