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Beginning hormone therapy

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User
Posted 10 Jun 2015 at 20:13

I'm here on behalf of my 54 year old brother, recently diagnosed with locally advanced T3a Pca which has possibly metastasied but nothing's showing on scans.  He was started on hormone therapy about 3 weeks ago and given anti-androgen tablets (Casodex I think) to take for only 3 days prior to the injection.  We saw his oncologist yesterday who said that he should have taken them for 6 days after as well but said that it was too late to do anything about it now.  I've since found out that it's common to take them for a whole 28 days after the first injection.

I'm confused. If I understand correctly, the tablets are taken to stop the initial flare at the beginning of HT and are quite important.  I'm worried that because he hadn't been told to take them properly, his cancer has been given a nice little boost right at the beginning of treatment! Or am I misinformed and the Casodex is used just to control symptoms such as bone pain? These questions of course didn't arise in yesterday's consultation because we weren't fully informed and the oncologist came across as being very unsympathetic.  

User
Posted 10 Jun 2015 at 23:12

I can only tell you about my experience - I have been on HT now for nearly 9 months.  Before starting the HT (a Zoladex implant) I was told I had to take 2 weeks worth of 50mg cyproterone acetate tablets (3 tablets per day) prior to and 2 weeks after the Zoladex implant was administered.  Making a total of 4 weeks  of cyproterone acetate to reduce the testosterone flare when the HT was started.   I don't know how this anti-androgen compares with Casodex though.  Hope this is of some use.

User
Posted 10 Jun 2015 at 23:12
Big sis

oh where to start ...

Casodex or bicultamide is often prescribed to be taken in a specific way around the first Zoladex or Prostap injection. It is normally taken for 7 days before and up to 21 after (presumably to use up a 28 day supply) its main job is to stop tumour flare which can be very distressing and painful.

I know from my OHs experience that there is often confusion on how to take the meds. I think that is sometimes down to poor communication between the hospital and the GP. The only thing I can say is that if your brother has had his injection and is doing oK then it may be best not to worry about it. The first line treatment is the injection.

I would ask the medical team what they now expect to happen at the next PSA test and if the lack of guidance on taking casodex might affect that?

best wishes

xx

Mo

User
Posted 11 Jun 2015 at 07:44

Martyn, hope all goes well with your treatment. Mo, thanks for your very sound advice. He hasn't had any severe symptoms so far so will try to stop worrying and will ask how it might affect the next PSA reading.

 
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