I don't know exactly how each drug works. With hormone blockers they either end in -relin or -utamide.
The -relins block production of testosterone and the -utamides block take up of testosterone. I don't doubt that some are more effective than others for example bicalutamide is fine in early stages but darolutamide is more effective for later stages.
The main effects, and side effects, of any HT is caused by the fact your cells aren't exposed to testosterone. In theory it shouldn't matter whether you are on a -relin or an -utamide. They should have the same effects, good or bad. In practice -relins are more likely to cause hot flushes and -utamides more likely to cause breast growth, so clearly there are differences. Also for advanced cancer both types of drug are used simultaneously with good effect.
On the face of it, if you are happier with the side effects of an -utamide over that of a -relin then go for it (obviously under the direction of an oncologist, not a bloke on the internet).
The point about the cost is interesting. I have little doubt a politician will be claiming the credit for subsidizing the cost of darolutamide. The reality is that abiraterone (brand name Zytega) has just became off patent and the generics are about 5% the cost of the brand name, so suddenly there is a price war in the prostate cancer drug market, from which you are benefiting: and politicians are taking the credit.
Now one might slag off "big pharma" for price fixing for the last 25 years, but it costs a fortune to develop and test several hundred drugs of which only a few are effective. Each tablet which costs about 50 pence to manufacture, needs to repay the cost of all the failed trials. If there was not a killing to be made whilst a drug is in patent, no one would invest in finding new drugs. Cancer treatment would not have advanced past, a course of blood letting with leeches.
Ofcourse, big pharma, isn't averse to taking a politician for a golf weekend, between it's drug going off patent and the generic being approved; a very long weekend.
Edited by member 17 Nov 2023 at 00:59
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User
Hi Dave,
Thanks for your reply. Makes a lot of sense. Love your comment about Leeches and blood letting 😆
I can't speak for others here, but personally, I often feel swamped by the vast amounts of information about PCa—treatments, drugs, tests, cancer types, and grades. It becomes overwhelming and can lead to its own set of mental challenges. In fact, I bet there's a forum for every disease or cancer type out there, that all have the one sole purpose, to help and assist those in need.
As a wise religious figure once said, "Being born human isn't a sin, but it's certainly unfortunate." He was himself a Doctor back in the 1830's and so you can imagine how limited they were in treating the multitude of issues facing mankind back then. But I still think that comment holds some weight today.
User
All the *utamides (Bicalutamide, Enzalutamide, Daralutamide, and Apalutamide) which are Androgen blockers will work by themselves, but Bicalutamide is the only one licensed for such use in the UK. The others are newer, much more effective (Enzalutamide binds to androgen receptors 8 times more strongly than Bicalutamide), and much more expensive, and can only be prescribed to a patient also on hormone therapy injections.
I don't know that there's much data out there on using the *utamides by themselves, except for Bicalutamide. The others do have higher risk side effects.
Bicalutamide is increasingly being used by itself with localised prostate cancer curative Radiotherapy treatment.
Edited by member 17 Nov 2023 at 11:26
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Can Nubeqa (Darolutamide) be used instead of normal ADT drugs for localized PCa?