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Bicalutamide or Decapeptyl?

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User
Posted 12 Apr 2022 at 07:36

Good Morning, 


T3a, G 7( 3+4) psa 8 age 64. 


Dr recommends the decapeptyl for 2 years.


But i have been offered staying on 150mg daily  bicalutamide for the two years instead.


Never having been on them, i have no clue!


Any patient experiences i can call on?


Which one will affect my quality of life the most.? 


Can you switch in the 2 years? 


Thanks

User
Posted 12 Apr 2022 at 10:34

Hi John,


Either will do the job and yes you can switch. Side effects will be similar. No libido, almost certainly, no erections unless you put in a lot of effort which you can't be bothered to do (you will need some advice on penile health). With bical you may start to develop breasts, this can be prevented if caught early, again others on here can advise. With decapeptyl you may get some irritation around the injection site. 


With either you may get hot flushes, and then less common side effects like mood swings, joint pain, and these could be different between the two drugs depending on your body.


I would find remembering to take the tablet daily a bit of a nuisance. I was on zoladex for two years, no major problems. I would just choose one and swap if you get a troublesome side effect .

Dave

User
Posted 12 Apr 2022 at 10:48

Hi John,


i was on Bicalutamide  for 14 days before starting Decapeptyl injections every 12 weeks.


I was fortunate that I had very few problems with the Decapeptyl, just a little soreness where it was injected.


See my thread on this where I was put back on HT when my PSA started rising.


https://community.prostatecanceruk.org/posts/t21462-Oh-dear---back-on-Hormone-Therapy


Arthur

User
Posted 12 Apr 2022 at 13:04
I was on 150mg bicalutimide for 18 months and didn't find it too bad. The main side effect other than the expected loss of libido was fatigue.

Cheers,

Chris
User
Posted 12 Apr 2022 at 14:58
I was on Bicalutamide 150mg for 11 months and had virtually no symptoms at except tiredness at the start. Libido remained healthy all the way through and no weight gain or flushes or sore moobs at all.
Now on Decapeptyl for life and still being lucky side effect wise. Libido has lowered but it’s still a weekly event tbh. I’ve lost the ability to orgasm mostly. No weight gain or moobs. Lots of flushes.
So in my experience Bicalutamide is the better of the two. After all Bicalutamide only lowers testosterone a small amount. It’s main purpose is to HIDE your testosterone from the cancer. But Decapeptyl and injectables chemically castrate you. A totally different cup of tea.
Good luck 🤞
User
Posted 13 Apr 2022 at 09:06
If you're on the Wirral, John, presumably you're being treated at Clatterbridge? I had my treatment there and couldn't have asked for better care. It seems to be one of the few places where bicalutimide is offered as a primary HT treatment.

Best wishes,

Chris
User
Posted 13 Apr 2022 at 13:22

I was on Bicalutimide for 18 months.


No loss of libido.


Continued to use invicorp injections for erections.


Tiredness and forgetfulness an issue.


Some weight gain.


Avoided man boobs by taking tamoxifen.


If I had to do it again, I'd choose Bicalutimide. 

User
Posted 13 Apr 2022 at 16:39

Hi Chris. Yes, Wallasey based. Clatterbridge looking after me.  They have been so good, most impressed.

User
Posted 13 Apr 2022 at 17:26
Not really, John, no. My oncologist said that he’d start me on bicalutimide, because he found that patients tolerated it better than the injectable hormones, but he’d switch to the injectables if he felt that my PSA wasn’t going down quickly enough. My PSA did go down fast, so I stayed on the bicalutimide, which I found pretty tolerable.

Very best wishes,

Chris
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User
Posted 12 Apr 2022 at 10:34

Hi John,


Either will do the job and yes you can switch. Side effects will be similar. No libido, almost certainly, no erections unless you put in a lot of effort which you can't be bothered to do (you will need some advice on penile health). With bical you may start to develop breasts, this can be prevented if caught early, again others on here can advise. With decapeptyl you may get some irritation around the injection site. 


With either you may get hot flushes, and then less common side effects like mood swings, joint pain, and these could be different between the two drugs depending on your body.


I would find remembering to take the tablet daily a bit of a nuisance. I was on zoladex for two years, no major problems. I would just choose one and swap if you get a troublesome side effect .

Dave

User
Posted 12 Apr 2022 at 10:48

Hi John,


i was on Bicalutamide  for 14 days before starting Decapeptyl injections every 12 weeks.


I was fortunate that I had very few problems with the Decapeptyl, just a little soreness where it was injected.


See my thread on this where I was put back on HT when my PSA started rising.


https://community.prostatecanceruk.org/posts/t21462-Oh-dear---back-on-Hormone-Therapy


Arthur

User
Posted 12 Apr 2022 at 13:04
I was on 150mg bicalutimide for 18 months and didn't find it too bad. The main side effect other than the expected loss of libido was fatigue.

Cheers,

Chris
User
Posted 12 Apr 2022 at 14:58
I was on Bicalutamide 150mg for 11 months and had virtually no symptoms at except tiredness at the start. Libido remained healthy all the way through and no weight gain or flushes or sore moobs at all.
Now on Decapeptyl for life and still being lucky side effect wise. Libido has lowered but it’s still a weekly event tbh. I’ve lost the ability to orgasm mostly. No weight gain or moobs. Lots of flushes.
So in my experience Bicalutamide is the better of the two. After all Bicalutamide only lowers testosterone a small amount. It’s main purpose is to HIDE your testosterone from the cancer. But Decapeptyl and injectables chemically castrate you. A totally different cup of tea.
Good luck 🤞
User
Posted 13 Apr 2022 at 09:06
If you're on the Wirral, John, presumably you're being treated at Clatterbridge? I had my treatment there and couldn't have asked for better care. It seems to be one of the few places where bicalutimide is offered as a primary HT treatment.

Best wishes,

Chris
User
Posted 13 Apr 2022 at 13:22

I was on Bicalutimide for 18 months.


No loss of libido.


Continued to use invicorp injections for erections.


Tiredness and forgetfulness an issue.


Some weight gain.


Avoided man boobs by taking tamoxifen.


If I had to do it again, I'd choose Bicalutimide. 

User
Posted 13 Apr 2022 at 16:39

Hi Chris. Yes, Wallasey based. Clatterbridge looking after me.  They have been so good, most impressed.

User
Posted 13 Apr 2022 at 17:12

Cheshire Chris. Did they give you a choice? Thats my problem! It was the 4 weeks bicalutamide and then decapeptyl and at last consultation it became or stay on bicalutamide. 


I want the best outcome, of course, but cant split the two!!


 

User
Posted 13 Apr 2022 at 17:26
Not really, John, no. My oncologist said that he’d start me on bicalutimide, because he found that patients tolerated it better than the injectable hormones, but he’d switch to the injectables if he felt that my PSA wasn’t going down quickly enough. My PSA did go down fast, so I stayed on the bicalutimide, which I found pretty tolerable.

Very best wishes,

Chris
User
Posted 13 Apr 2022 at 19:02
Everyone that starts on injectables tends to have a months Bicalutamide first. This prevents tumour flare from attacking the cancer too quickly
User
Posted 13 Apr 2022 at 19:45

I was misrrable when he said 2 years ht. Even more so when its pick your own!

 
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