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LHRH side effect comparison

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User
Posted 24 Mar 2018 at 08:54

I have just started using Bicalutamide 150mg (with little in the way of side effects) and await my first injection of LHRH. My Oncologist has listed three types for my GP to choose from. Before I hand the prescription in does anyone have an opinion on which carries the least side effects and is generally tolerated better?

1. Zoladex LA 10.8mg

2. Prostrap 3DCS 11.25mg

3. Decapeptyl SR 11.25mg

All are intended for three monthly injections with a total of three planned.

As always, all help appreciated.

David.

User
Posted 24 Mar 2018 at 10:52

Zoladex must be given every 12 weeks and goes into the stomach - the nurse should be trained to do it properly.

Prostap is injected into muscle so the site can be changed if you get sore. It is given monthly or 3 monthly so is a bit more flexible but it has to be stored correctly.

Decapeptyl is also given into muscle, usually the bum, and is monthly / 3 monthly.

Usually, for all of these they only give a 4 week / 1 month dose the first time, and 12 weekly / 3 monthly doses thereafter. That is just to ensure you can tolerate it.

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

User
Posted 24 Mar 2018 at 13:40

Just to addca footnote, if youngish for Zoladex it goes into alternate sides of the belly. Inevitably, as it is a big needle, it can cause bruising, so don't expect the site to be too beautiful for two or three weeks afterwards! However skilled the nurse, sometimes a blood vessel might be hit to cause the bruising. But it doesn't hurt, especially if the nurse is quick!

User
Posted 24 Mar 2018 at 16:52

Hi David,

I had most of the usual side effects when I had the LHRH.

I asked if I could switch drugs and the Oncologist explained the side effects were caused by the body’s response to the treatment, turning off the testosterone, not the drugs themselves, all of which have the same function. ie side effects are the same whichever LHRH you have.

Mine, Zoladex, were injected in the belt line, no bruising or pain, just a ‘sharp scratch’ and nothing to worry about.

User
Posted 25 Mar 2018 at 02:47

In accord with what has been said, it can take some men quite a time for their bodies to become used to the effects of these and some men are not so severely affected as others. I think I was quite lucky with SE of Zoladex but did not have the other two. The worse thing from my experience was the fatigue which for example meant to player fewer games of short tennis in each session. I think it would be very easy to sit down more and lose fitness .

Barry
User
Posted 25 Mar 2018 at 08:50
My husband had zolodex then he was switched to Prostap after a couple of years, he says that he really didn’t notice any difference in the side effects. As for the injection site the zolodex went into the belly alternating different sides each three month interval, he continued to use the same site for Prostap and always goes to the same nurse at his gp practice.
User
Posted 08 May 2018 at 09:15

Well to update things I am now six weeks into HT with the Bicalutamide finished two weeks ago so it's been a month on Prostap (which went into the left upper buttock). In general I feel well. The AA tablets did produce noticeable fatigue but no hot flushes or other symptoms of note. The Prostap has slowly introduced flushes but only at night. I have none by day and apart from a tendency to tire if I push myself too hard I am doing fine. I even got my pilots licence medical back with my Doctor saying that if he hadn't known about the PCa he would not have thought me ill in any way. (You can have your licence back after four weeks post treatment for HT/RT. Four to six weeks post RP)

The only thing that is a nuisance is that sleeping tends to come in blocks of two hours or so with waking in hot flushes. Night urinary motions have never been an issue with me but I have now gone from an average of one, to two or three. Not sure why since nothing has changed in my dietary habits. That said, I have now replaced alcohol intake over dinner with a mixture of Apple and Cranberry juice, so maybe I need to go back to wine and beer ;-) A few nights a week I still enjoy some wine with no real ill effect but it's noticeable that too much will see me tired the next day. 

I was offered SD Brachy followed by three weeks of IGIM RT or four straight weeks of RT. I've elected for the latter as by the time I've found my way to Manchester for three weeks, we might as well do the extra fourth and avoid another surgical procedure.

I know that this forum is not a place of humour, which is understandable. But I have come to the following conclusion about having PCa, and that is that the stress of having the illness is dwarfed by the stress of dealing with consultant's secretaries and the combined stress of both become totally irrelevant compared to the stress of trying to find a parking space at an NHS hospital. 

 

Good luck and good health to everyone. 

David.

Edited by member 09 May 2018 at 12:30  | Reason: Not specified

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User
Posted 24 Mar 2018 at 10:52

Zoladex must be given every 12 weeks and goes into the stomach - the nurse should be trained to do it properly.

Prostap is injected into muscle so the site can be changed if you get sore. It is given monthly or 3 monthly so is a bit more flexible but it has to be stored correctly.

Decapeptyl is also given into muscle, usually the bum, and is monthly / 3 monthly.

Usually, for all of these they only give a 4 week / 1 month dose the first time, and 12 weekly / 3 monthly doses thereafter. That is just to ensure you can tolerate it.

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

User
Posted 24 Mar 2018 at 13:40

Just to addca footnote, if youngish for Zoladex it goes into alternate sides of the belly. Inevitably, as it is a big needle, it can cause bruising, so don't expect the site to be too beautiful for two or three weeks afterwards! However skilled the nurse, sometimes a blood vessel might be hit to cause the bruising. But it doesn't hurt, especially if the nurse is quick!

User
Posted 24 Mar 2018 at 16:52

Hi David,

I had most of the usual side effects when I had the LHRH.

I asked if I could switch drugs and the Oncologist explained the side effects were caused by the body’s response to the treatment, turning off the testosterone, not the drugs themselves, all of which have the same function. ie side effects are the same whichever LHRH you have.

Mine, Zoladex, were injected in the belt line, no bruising or pain, just a ‘sharp scratch’ and nothing to worry about.

User
Posted 25 Mar 2018 at 02:47

In accord with what has been said, it can take some men quite a time for their bodies to become used to the effects of these and some men are not so severely affected as others. I think I was quite lucky with SE of Zoladex but did not have the other two. The worse thing from my experience was the fatigue which for example meant to player fewer games of short tennis in each session. I think it would be very easy to sit down more and lose fitness .

Barry
User
Posted 25 Mar 2018 at 08:50
My husband had zolodex then he was switched to Prostap after a couple of years, he says that he really didn’t notice any difference in the side effects. As for the injection site the zolodex went into the belly alternating different sides each three month interval, he continued to use the same site for Prostap and always goes to the same nurse at his gp practice.
User
Posted 08 May 2018 at 09:15

Well to update things I am now six weeks into HT with the Bicalutamide finished two weeks ago so it's been a month on Prostap (which went into the left upper buttock). In general I feel well. The AA tablets did produce noticeable fatigue but no hot flushes or other symptoms of note. The Prostap has slowly introduced flushes but only at night. I have none by day and apart from a tendency to tire if I push myself too hard I am doing fine. I even got my pilots licence medical back with my Doctor saying that if he hadn't known about the PCa he would not have thought me ill in any way. (You can have your licence back after four weeks post treatment for HT/RT. Four to six weeks post RP)

The only thing that is a nuisance is that sleeping tends to come in blocks of two hours or so with waking in hot flushes. Night urinary motions have never been an issue with me but I have now gone from an average of one, to two or three. Not sure why since nothing has changed in my dietary habits. That said, I have now replaced alcohol intake over dinner with a mixture of Apple and Cranberry juice, so maybe I need to go back to wine and beer ;-) A few nights a week I still enjoy some wine with no real ill effect but it's noticeable that too much will see me tired the next day. 

I was offered SD Brachy followed by three weeks of IGIM RT or four straight weeks of RT. I've elected for the latter as by the time I've found my way to Manchester for three weeks, we might as well do the extra fourth and avoid another surgical procedure.

I know that this forum is not a place of humour, which is understandable. But I have come to the following conclusion about having PCa, and that is that the stress of having the illness is dwarfed by the stress of dealing with consultant's secretaries and the combined stress of both become totally irrelevant compared to the stress of trying to find a parking space at an NHS hospital. 

 

Good luck and good health to everyone. 

David.

Edited by member 09 May 2018 at 12:30  | Reason: Not specified

 
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