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Which LHRH type alongside radiotherapy? - LHRH,Hormone therapy (HT / ADT / IMHT)

User
Posted 20 Feb 2017 at 15:16

So - latest is that OH has agreed to 3 months of hormone therapy prior to radiotherapy (plus a further 3 months to overlap with RT and continue for 2 months afterwards); he started bicalutamide last week and next week will have his first LHRH injection. He seems to have the choice of Goserelin (Zoladax), Leuprorelin (Prostap) or Triptorelin (Decapeptyl) - monthly or 3-monthly. Any opinions re choosing between them? 

Many thanks

Janet 

User
Posted 20 Feb 2017 at 16:51

Hi Janet,

At various times in the past I have been on Zoladex and Prostrap, in all honesty I don't think that there is much to choose between them.

In some senses the so called 'side effects' aren't really side effects of the medication, they are the consequences of going without testosterone, which is after all the whole point of the treatment.

Personally I had lots of hot flushes, my body hair stopped growing and I didn't need to shave so often, over time I noticed muscle loss, and your other half will need to give some thought to a healthy diet, as weight gain is another common 'side effect'.

Libido, or rather the lack of it, is also a common problem.  Anyone with PCa is entitled to Viagra, but I had to specifically ask my GP, it wasn't offered unless you asked.  I found they worked for the first couple of months on Zoladex, but after that I was flogging a dead horse. 

Some other chaps on this site seem to often have problems with their man boobs and sore nipples, but personally I didn't experience that.

For me Prostrap was easiest as it's given as a normal fluid injection in the arm, soreness persists for a day or two.

One of the problems with Zoladex is it is a pellet inserted into the abdomen, and the nurses don't seem to like to put them in the same place twice in a row.  If your surgery is anything like mine, the nurses don't seem to keep a record of where they inserted the last one and rely on the patient to remember, so I got in the habit of following the seasons around my navel, in the winter inject above the navel, in the spring to the left, in the summer below the navel etc. 

I used to have 3 monthly injections, technically they are 12 weekly, but it doesn't really matter if you are a week or two late.  I used to get my PSA tested at the same time.

I have found it takes quite a while after the last injection before the effects wear off, I had my last jab 18 months ago and am only just noticing my body hairs growing back with vigour.

Good luck.

:)

Dave

User
Posted 20 Feb 2017 at 18:03

Prostap is given every month or three months and is easier to inject. Decapeptyl is also a monthly / 3 monthly dose and some prefer it because it is injected into the buttock rather than the thigh or belly.

Zoladex must be given every 4 or 12 weeks (not monthly or 3 monthly) and the nurse should be trained in a) how to store it correctly and b) how to administer it - we have had a couple of sad stories on here of men whose GP practice was unaware of the importance of this, resulting in PSA rises and increased met activity.

Generally, it is seen to be a good idea to start with the monthly dose the first time and see how you go with it before moving to 3 monthly shots. Obviously once you are on 3 monthly it is easier to fit in holidays etc but if the side effects are awful you are stuck with them for longer.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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