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Travelling when taking hormone therapy

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User
Posted 25 May 2022 at 18:36
Hi everyone

 

My partner had a prostatectomy and lymph node dissection in June 2021. Unfortunately, the PSA was still detectable and has slowly been on the rise - now 0.52. Although scans still can't show exactly where it has spread to, he will start radiotherapy for 6.5 weeks to try and zap it. He'll be starting a 28 day course of Bicalutamide tomorrow, with injection mid-way. What are people's experiences with side effects? We're travelling to New York next week and I'm worried he will be exhausted and really suffer with hot flushes in the humidity. Is there a better time of day to take it and with or without food? Any advice welcome. Thanks all.
User
Posted 25 May 2022 at 19:54
MCD2021, I am someone currently on hormone therapy. I don't recall any real problems with the bicalutimide and just like your partner it was only for a short period either side of my first Zoladex injection.

On Zoladex while waiting for radiotherapy (which got delayed for various reasons, but should start in the next few weeks) I have so far been on three skiing holidays and one cycling/tourism holiday with no problems. (You may tell, after all the issues of Covid we are taking what opportunities we can to have fun while we are able to).

No problems with those.
User
Posted 25 May 2022 at 19:33

CT scans. Apparently v difficult to detect anything lower than 0.5 PSA

User
Posted 09 Jun 2022 at 16:30

We've just returned and all went fine, apart from OH feeling generally grotty because of the medication. We made the most of it though. Insurance-wise the most comprehensive cover was by Saga, however it was £550... for peace of mind it was worth it. Hope you get to Chicago and have a wonderful time.

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User
Posted 25 May 2022 at 19:07

Side-effects take weeks to build up, and the dosage of bicalutimide he'll be on to prevent "tumour flare" prior to injections is a low one which is of itself unlikely to cause any issues at all. I'm sure he'll be fine.


It doesn't matter when you take bicalutimide. It's not like paracetamol, acting instantly. It slowly builds up in the body over weeks. I took mine when I got up in the morning, but take it any time.


Best wishes,


Chris

Edited by member 25 May 2022 at 19:09  | Reason: Not specified

User
Posted 25 May 2022 at 19:09
Bical isn't going to affect him that quickly, apart from possibly a bit of shortness of breath if he is climbing the Empire State building or something.

More pressing - have you notified the travel insurer of the new medication? They may not be willing to cover him in which case it would be wise to ask the onco to delay starting bical until you get back
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 25 May 2022 at 19:21

Thank you for the advice, keeping everything crossed it doesn’t impact. He’s insistent he wants to start ASAP. Insurance is £550 and very detailed health assessment was completed! But life’s short and for living. 

User
Posted 25 May 2022 at 19:28

MCD, what scans did he have ? 


Thanks Chris

User
Posted 25 May 2022 at 19:33

CT scans. Apparently v difficult to detect anything lower than 0.5 PSA

User
Posted 25 May 2022 at 19:45

Originally Posted by: Online Community Member


Thank you for the advice, keeping everything crossed it doesn’t impact. He’s insistent he wants to start ASAP. Insurance is £550 and very detailed health assessment was completed! But life’s short and for living. 



Absolutely! 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 25 May 2022 at 19:54
MCD2021, I am someone currently on hormone therapy. I don't recall any real problems with the bicalutimide and just like your partner it was only for a short period either side of my first Zoladex injection.

On Zoladex while waiting for radiotherapy (which got delayed for various reasons, but should start in the next few weeks) I have so far been on three skiing holidays and one cycling/tourism holiday with no problems. (You may tell, after all the issues of Covid we are taking what opportunities we can to have fun while we are able to).

No problems with those.
User
Posted 25 May 2022 at 19:57

Hi @J-B, glad to hear you’re managing to enjoy holidays now! Good luck with your treatment. 

User
Posted 07 Jun 2022 at 10:25

Thanks for that. OH is leaning towards Radiotherapy and we are due to go to Chicago to see family including grandson. It sounds possible (we will need to get insurance sorted out though)

"Time is like a drug. Too much of it kills you." - Terry Pratchett

User
Posted 09 Jun 2022 at 16:30

We've just returned and all went fine, apart from OH feeling generally grotty because of the medication. We made the most of it though. Insurance-wise the most comprehensive cover was by Saga, however it was £550... for peace of mind it was worth it. Hope you get to Chicago and have a wonderful time.

User
Posted 13 Jun 2022 at 21:30
Help would be appreciated. OH has bicalutimide prescribed for four week and they have also prescribed the Zoladex injection and we have the packet with that in. We are going to the US for five weeks but the injection needs to be given in four weeks. They have said a few days does not matter but the bicalutimide starts on Saturday and we do not leave until Tuesday so we are either going to have to come back a few days early and try and change the flight or get the injection done in the US. Has anyone had any experience of getting hormone injections while abroad. Obviously we would have to pay but that is not an issue.

"Time is like a drug. Too much of it kills you." - Terry Pratchett

User
Posted 13 Jun 2022 at 21:55
As it will be his first injection there is more to think about than just getting someone to give the injection- it has to be stored correctly and at the right temperature (might be difficult on a long flight especially if it is in hand luggage), you need a nurse or medical practitioner who is trained in giving zoladex and what if he has a severe reaction to it (rare but not unheard of which is why the first one tends to be a 1 month dose and then they move to 3 monthly).

Ask the onco or specialist nurse whether you can delay starting the bicalutimide by a week so that the first zoladex injection is due after you get back. Also confirm the 4 week thing - it is common for the bicalutimide to be for 4 weeks but the first injection is in the middle of the 4 weeks not at the end.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 13 Jun 2022 at 22:19

Absolutely agree with Lyn. I can not imagine a US doctor injecting imported drugs in to your OH, it may not even be licensed for use in the US, and is definitely not a regular hypodermic, you need to be trained to use the applicator.


As Lyn says it is usually a 28 day course of tablets with the injection at day 14 (not day 28). So either delay the bicalutamide or start now but stay on it for 6 or 8 weeks, as long as zoladex starts about 14 days before last bicalutamide all will be ok.

Dave

User
Posted 13 Jun 2022 at 22:35
Thanks - very useful replies. We have checked and it is FDA approved and used a lot in the US. What has been prescribed is one implant in a prefilled syringe. The oncologist suggested taking it to the US and doing it there ourselves if I was a nurse (which I am not!). He definitely said do the injection at the end of the 28 day course (or fairly close to that). They do not want to delay start of hormones as OH is Gleason 9 and the biopsy showed cancer in a lot of places and a lot in each place but it still seems localised at present.

However the risk of adverse reaction is certainly one we do not want to risk abroad. May need to change flight home by a few days

"Time is like a drug. Too much of it kills you." - Terry Pratchett

 
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