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Typical treatment schedule?

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User
Posted 22 Mar 2020 at 08:35
My dad started his prostate cancer treatment on Monday 16th March 2020 (hormone tablets).  He has an injection booked in at his GP on Monday 30th March 2020 (2 weeks later).  We are little confused what happens next! I sat with him when he got the results and it became a bit of blurr. 

 

1) Is he expected to take the hormone tablets for a minimum of 3 months? The doctor mentioned something about 3 month's.

2) When is he likely to start the daily radiation treatment at hospital for 7 weeks?

3) How often is he likely to require the injection at his GP?

 

I think the injection is the LHRC Agonist and the hormone tablets are daily bicalutamide 50mg.

 

He has Gleason Score of 4+5=9 and PSA 2. He is 75 years old and we have been told the cancer is localised.

 

Thanks, Richard.

 
User
Posted 22 Mar 2020 at 09:24

Hi Richard, it’s normal to start on bicalutamide which prevents the cancer using testosterone as a fuel. The next usual step is to start on the LHRH agonists like PROSTAP which stops the body making testosterone.

He is likely to be on hormone therapy for at least three months before radiotherapy. Evidence suggests being on HT for up to six months prior to radiotherapy helps it work more effectively by weakening the cancer.

Depending on his cancer and his oncologist your Dad May be asked to stay on HT for up to three years in total.

I wish your Dad all the best with this.

See these links

https://prostatecanceruk.org/prostate-information/treatments/hormone-therapy

https://prostatecanceruk.org/prostate-information/treatments/external-beam-radiotherapy

Ido4

User
Posted 22 Mar 2020 at 10:25

Hi Richard,

I started having Prostap injections in January 2013, because of my situation I had a catheter fitted, had a TURP procedure in the June.  I started radio therapy in the September.  I continued to have the injections at 12 weekly intervals until November 2015.

Best wishes, Arthur

User
Posted 22 Mar 2020 at 11:19

I was on bicalutomide for 2 weeks (to prevent 'cancer flare') then a 1 month injection of Prostap at the hospital, then 2 x 3 month injections (3 months apart, naturally) at my local surgery. Prostap seems to come in 1 month or 3 month doses. I started radiotherapy in the middle of October 2019 and had my last session (of 20) on November 12th. It is usually 20 or 37 daily radiotherapy sessions, given every week day. Patients get the weekends off to recover! Now I am waiting for a blood test to check my PSA level (hopefully almost nothing) and I have an appointment with the oncologist at the start of June. I also had a session with a senior nurse practitioner at the start of February, just to check that my recovery was going as expected, which it was. If I had had any questions or worries, I had a number at the hospital which I could have called. I am lucky - after my last Prostap injection in September, I am not due to have any more. The actual process is a bit long and drawn-out, but I would say it is not especially arduous. The hormone injections have side effects, as does the radio therapy, but they can be managed, and they pass. If you are not clear on anything, just ask. Another brilliant resource is the specialist nurse 'phone support from Prostate Cancer UK - just give them a call and they will be able to tell you whatever you want to know.
Best wishes,
Hermit of Eyam

User
Posted 22 Mar 2020 at 13:58

His situation sounds like mine. I started same tablets on 19 March so I`m new to it. I`m 75 too. What worries me is where I will have my injection. An article in the paper today said us oldies should avoid GP surgeries. The consultation I had on Thursday had to be done by phone. The specialist didn`t want me going to the hospital because of the corona virus so I assume I shouldn`t go there for the injection either. I suppose I will have to see what the letter says about the injection. I will also have to obtain a repeat prescription without going to the surgery. Everything seems to be up in the air at the moment & it takes over your mind.

User
Posted 22 Mar 2020 at 18:35
Actually, there is very little variation for men on a HT / RT curative path or long term HT (non curative) - 2-4 weeks of bicalutamide tablets, 1st hormone injection 2 weeks after bical started, and then either monthly or 3 monthly injections after that for a period of 9-18 months (on curative path) or indefinitely (non-curative path). Radiotherapy (if offered) usually begins 3 - 6 months after the HT started.

Some men on curative path used to have the hormone injections for up to 3 years but that is rare now as research showed the extra time made no difference to outcomes. Some men have a hormone that actually comes in a 6 month injection but almost everyone has the one month dose the first time just in case they react really badly to it. A very small % of men just have bical for a few months and no injections but again, this is less popular with oncologists now.

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

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User
Posted 22 Mar 2020 at 09:24

Hi Richard, it’s normal to start on bicalutamide which prevents the cancer using testosterone as a fuel. The next usual step is to start on the LHRH agonists like PROSTAP which stops the body making testosterone.

He is likely to be on hormone therapy for at least three months before radiotherapy. Evidence suggests being on HT for up to six months prior to radiotherapy helps it work more effectively by weakening the cancer.

Depending on his cancer and his oncologist your Dad May be asked to stay on HT for up to three years in total.

I wish your Dad all the best with this.

See these links

https://prostatecanceruk.org/prostate-information/treatments/hormone-therapy

https://prostatecanceruk.org/prostate-information/treatments/external-beam-radiotherapy

Ido4

User
Posted 22 Mar 2020 at 10:25

Hi Richard,

I started having Prostap injections in January 2013, because of my situation I had a catheter fitted, had a TURP procedure in the June.  I started radio therapy in the September.  I continued to have the injections at 12 weekly intervals until November 2015.

Best wishes, Arthur

User
Posted 22 Mar 2020 at 11:19

I was on bicalutomide for 2 weeks (to prevent 'cancer flare') then a 1 month injection of Prostap at the hospital, then 2 x 3 month injections (3 months apart, naturally) at my local surgery. Prostap seems to come in 1 month or 3 month doses. I started radiotherapy in the middle of October 2019 and had my last session (of 20) on November 12th. It is usually 20 or 37 daily radiotherapy sessions, given every week day. Patients get the weekends off to recover! Now I am waiting for a blood test to check my PSA level (hopefully almost nothing) and I have an appointment with the oncologist at the start of June. I also had a session with a senior nurse practitioner at the start of February, just to check that my recovery was going as expected, which it was. If I had had any questions or worries, I had a number at the hospital which I could have called. I am lucky - after my last Prostap injection in September, I am not due to have any more. The actual process is a bit long and drawn-out, but I would say it is not especially arduous. The hormone injections have side effects, as does the radio therapy, but they can be managed, and they pass. If you are not clear on anything, just ask. Another brilliant resource is the specialist nurse 'phone support from Prostate Cancer UK - just give them a call and they will be able to tell you whatever you want to know.
Best wishes,
Hermit of Eyam

User
Posted 22 Mar 2020 at 13:58

His situation sounds like mine. I started same tablets on 19 March so I`m new to it. I`m 75 too. What worries me is where I will have my injection. An article in the paper today said us oldies should avoid GP surgeries. The consultation I had on Thursday had to be done by phone. The specialist didn`t want me going to the hospital because of the corona virus so I assume I shouldn`t go there for the injection either. I suppose I will have to see what the letter says about the injection. I will also have to obtain a repeat prescription without going to the surgery. Everything seems to be up in the air at the moment & it takes over your mind.

User
Posted 22 Mar 2020 at 14:54
Thanks for the replies and links.

There seems to lots of treatment variations. I'll give the NHS Specialist Nurse a call on Monday to get a better understanding of what will happen. It is a relief he has started his treatment before covid-19 situation has escalated. Still a worry for everyone, but have to stay positive.

All the best, Richard.

User
Posted 22 Mar 2020 at 18:35
Actually, there is very little variation for men on a HT / RT curative path or long term HT (non curative) - 2-4 weeks of bicalutamide tablets, 1st hormone injection 2 weeks after bical started, and then either monthly or 3 monthly injections after that for a period of 9-18 months (on curative path) or indefinitely (non-curative path). Radiotherapy (if offered) usually begins 3 - 6 months after the HT started.

Some men on curative path used to have the hormone injections for up to 3 years but that is rare now as research showed the extra time made no difference to outcomes. Some men have a hormone that actually comes in a 6 month injection but almost everyone has the one month dose the first time just in case they react really badly to it. A very small % of men just have bical for a few months and no injections but again, this is less popular with oncologists now.

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

User
Posted 23 Mar 2020 at 07:59
Something that does help symptoms, but not always offered - is Tadalafil 5mg. Your GP should supply them. I had help with this from a specialist nurse at the hospital.
User
Posted 23 Mar 2020 at 11:37
It would be wise to give the hormones a chance to work first, though
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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