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Degarelix v Decapeptyl - Hormone therapy (HT / ADT / IMHT)

User
Posted 25 Feb 2018 at 13:02

Hi All

I started on Degarelix December 17.  Normal protocol here is 3 x monthly injections, then Decapeptyl every 3 or 6 months.  From what I can pick up, both are equally effective as testosterone blockers.  I'm halfway through my 6X Docetaxel chemo and nervous about changing because of a couple of factors and wonder if anyone has advice.

When I presented I had constant lower back pain, and a stiff neck whick meant I could not reverse the car out the drive properly.  Turns out the cancer had spread up the spine to my skull.  I had pain killers, neoproxine and to counterbalance the gastro effects Omeprazole, but after a week or so on the HT they were no longer needed.  I also had severe and consistant night sweats since the October that disappeared and a persistant, dry irratable cough I'd had for a couple of years that went as well.  The Degarelix is the only GnRH blocker, or LHRH antiagonist that stands apart from LHRH agonists like Decapeptyl.  There's the obvious benefit of changing - having an injection every 6 months instead of every month; but I'm worried my old symptoms may come back.

There's also a NICE report from 2016 that says a for a few sub-groups, including people with spinal metastases that are in danger of spinal cord compression, it may be best to stay on the Degarelix as it appears to offer long-term clinical benefit, which is particularly important for people with advanced disease.

I am now pain free and have recovered mobility, I worry that compression could occur. I feel my spine is giving me a warning any time I lift anything mildly heavy. It's only natural I want to minimise potential fracture or compression, or improve overall survival. Anyone been in this situation?  Thanks.

 

 

User
Posted 18 May 2018 at 16:50

Hi Tony,

Nice to see a fellow Liverpudlian on here, (though I am sorry that you need to be here).

I was diagnosed in July 2015 and was put on Degarilex immediately. I did react to it quite badly some months, but my onco told me that if I stopped it, I would feel much worse. Hence I carried on with it for more than two years, even though its effectiveness diminished over time and my PSA began to rise dramatically.

I started a course of Docetaxel chemotherapy in October last year and my first session of chemo coincided with my Degarlex injection. The combination of the two did me no good at all and I ended up in hospital overnight. So I finally managed to convince the onco that I should stop the Degarlilex. He put me on to Decapeptyl instead and I find this much easier to cope with (though I am not sure how its effectiveness compares).

I have now finished the chemotherapy and I have been feeling so much better, though my PSA is rising again, so it is time to consider further treatment options.

I understand your fears regarding fracture or compression. I am the same. I have extensive mets in my spine and particularly my pelvic area, though not, as far as I know, as far as my skull. I do find that I am unable to bend sufficiently to pick anything up off the floor and I avoid any heavy lifting. I also started using a walking stick from very early on, mainly as a safeguard against losing balance and falling. To do so could be devastating to someone in our position.

If you are tolerating Degarelix well, I would stay on it. It is clearly the best HT treatment available (and not everyone gets the chance of having it because of the expense) But I think for me, I would prefer the Decapeptyl.

We are all different!

Best wishes

Peter

 
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