Talk Cancer

Question:

Have any of you guys suffered lower back, pelvic area or thigh pain attributable to Zoladex and/or Casodex?

Response:

I have pain in the areas you mentioned but it is from the cancer, not from the meds. I had a load of other problems from the meds.  They actually lessoned the pain.  Before i started treatment the pain was nearly unbearable. i’m also getting Zometa to help restore the bone that has been damaged. Jim – Hide quoted text — Show quoted text -Have any of you guys suffered lower back, pelvic area or thigh pain attributable to Zoladex and/or Casodex?

Response:

Have any of you guys suffered lower back, pelvic area or thigh pain attributable to Zoladex and/or Casodex?

My GP (PCP) got me to have a series of lumbar and leg X-Rays when I complained of odd pains to my left leg from the thigh to the ankle and particular chronic bad pain to my L knee. I was found to have mild narrowing of L4/5 vertebral disc space plus anterior subluxation of L4 to L5, which suggests intermittent spinal chord compression causing Sciatic nerve related pain. There was also some suspect cartilage damage to the L knee, plus overall DJD (Osteo-Arthritis) to lower spine and both knees. I’m having an Arthroscopy done on the L knee next week to clean out any damaged cartilage segments. Nobody will admit to a cause or connection to my PCa treatment. 18 mths ADT (Lucrin) plus EBRT x 23 and HDRB x 3.  (I was never given a Bone Mineral Density test at the beginning because there was "no evidence of weak bones or recent fractures, consistent with Osteo-Porosis.") My take on all this is, that the ADT has caused general weakening of the bones and connective tissue, plus previous DJD problems to become worse, plus my spine and L knee cartilage were disturbed by rough handling during the HDRB treatment period of 48hrs immobilisation by the Epidural. I cannot definitively PROVE any of this and they "ain’t sayin". Any admission on their part may cause me to sue them! — Reader to complete… — Please reply to this ng as my email adress is fake: — Regards — CC

Response:

Have any of you guys suffered lower back, pelvic area or thigh pain attributable to Zoladex and/or Casodex?

I know that "joint pain" is a known and very common side effect of Lupron.  I wouldn’t be surprised if Zoladex has similar side effects.  Unfortunately, many doctors who prescribe these drugs don’t warn their patients about these common side effects or take any action to prevent them. Some doctors don’t even know about them.  They haven’t even read the labels on the drugs they prescribe. I don’t know what the best thing for joint pain is.  In my case, I experienced joint pain in fingers and toes starting about 8 months after starting Lupron – even though I had already stopped.  After trying anti-inflammatory drugs with no noticeable effect, I began doing very frequent, regular exercises.  I started with easy exercises that mainly involved movement and flexibility, gradually building up to strength building exercises.  I did huge numbers of them. Within a few months my pain was completely gone and is still gone.  I still do the exercises, but no longer in huge numbers. Your mileage may vary.     Alan

Response:

Nobody will admit to a cause or connection to my PCa treatment. 18 mths ADT (Lucrin) plus EBRT x 23 and HDRB x 3. (I was never given a Bone Mineral Density test at the beginning because there was "no evidence of weak bones or recent fractures, consistent with Osteo-Porosis.")

I, also, did not get a BMD Baseline (I did my own Dexa but no qCT was ordered) before injecting Lupron, I consider it a serious oversight on the uro’s part. My take on all this is, that the ADT has caused general weakening of the bones and connective tissue, plus previous DJD problems to become worse, plus my spine and L knee cartilage were disturbed by rough handling during the HDRB treatment period of 48hrs immobilisation by the Epidural.

Clarence, please state what was the volume/weight of your prostate at start of HDRB?  Mine was 23g at biopsy 4 months ago (start of Lupron) and was told by the RadOnc that 23 was too small for HDRB.  He’s the only source of this assertion (that a prostate can be too small for HDRB) that I can find.

Response:

… Clarence, please state what was the volume/weight of your prostate at start of HDRB?  Mine was 23g at biopsy 4 months ago (start of Lupron) and was told by the RadOnc that 23 was too small for HDRB.  He’s the only source of this assertion (that a prostate can be too small for HDRB) that I can find. …

Brian, I was in a clinical trial of magnetic resonance imaging guided HDRB.  I had Lupron before the radiation.  I was told before any treatment that my prostate was 40 grams.  When it came time for the HDRB, the rad onc told me my prostate was tiny (Lupron causes it to shrink.)  But they apparently had no problem doing the HDRB – though they were using MRI instead of ultrasound to guide the placement of the catheters – which might have been a factor. Does the rad onc say no brachytherapy at all, or just no High Dose Rate Brachytherapy? Is he a guy that specializes in prostates, or does he mainly do other types of cancer?  It’s possible that he feels that the 23 gram size is not within his limits of skill – in which case you sure don’t want him to do it.  But it’s possible someone else can.  You might want to check – hopefully with someone who won’t just say, "Yes I can do it" because he wants your business and doesn’t care if he hurts you in the process. However external beam radiation is also an excellent option. it is my understanding that EBRT and brachytherapy get very similar results. Good luck.     Alan

Response:

<snip Clarence, please state what was the volume/weight of your prostate at start of HDRB?  Mine was 23g at biopsy 4 months ago (start of Lupron) and was told by the RadOnc that 23 was too small for HDRB.  He’s the only source of this assertion (that a prostate can be too small for HDRB) that I can find.

72 cc at entry, shrunk to 65 cc after 3 mths ADT. But I also went into PCa treatment with BPH. ergo I cannot advise you on how "small" a gland should be. The median for HDRB is around 36 cc. Incidentally, 1cc = 1 gram, dependent on the Labs take on it. — Reader to complete… — Please reply to this ng as my email adress is fake: — Regards — CC

Response:

Aha!  I’ve had 2 ruptured discs for many years, been on Zoladex and Casodex for almost a year and had 25 sessions of EBRT during July and August of this year and then 3 sessions  of HDR brachytherapy on August 29 and 30.  BTW – even Astra-Zeneca’s website refers to back pain and bone pain for each of the 2 drugs. I had bone density and bone scans (for mets) in February when I first started on the meds and had another bone scan in July – fortunately negative.

Response:

My experience is essentially the same.  L4/L5 rupture in 1982.  It’s been sore to painful for 23 years, but no difference after Lupron.  Had dexoscan six months ago and no problems there, though I am taking Fozomax and calcium. — Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA  .1  .1  .1  .27  .37  .75 PSA  .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA  .07 .05 .06 .05 .08 Non Illegitimi Carborundum

– Hide quoted text — Show quoted text – Aha!  I’ve had 2 ruptured discs for many years, been on Zoladex and Casodex for almost a year and had 25 sessions of EBRT during July and August of this year and then 3 sessions  of HDR brachytherapy on August 29 and 30.  BTW – even Astra-Zeneca’s website refers to back pain and bone pain for each of the 2 drugs. I had bone density and bone scans (for mets) in February when I first started on the meds and had another bone scan in July – fortunately negative.

Response:

- Hide quoted text — Show quoted text – … Clarence, please state what was the volume/weight of your prostate at start of HDRB?  Mine was 23g at biopsy 4 months ago (start of Lupron) and was told by the RadOnc that 23 was too small for HDRB.  He’s the only source of this assertion (that a prostate can be too small for HDRB) that I can find. … Brian, I was in a clinical trial of magnetic resonance imaging guided HDRB.  I had Lupron before the radiation.  I was told before any treatment that my prostate was 40 grams.  When it came time for the HDRB, the rad onc told me my prostate was tiny (Lupron causes it to shrink.)  

No number on the size? I don’t know my size either, was 23 grams (and yes the lupron has made the prostate tiny and soft, too.) But they apparently had no problem doing the HDRB – though they were using MRI instead of ultrasound to guide the placement of the catheters – which might have been a factor. Does the rad onc say no brachytherapy at all, or just no High Dose Rate Brachytherapy?

HDR: DSQ because prostate was too small LDR: DSQ because of Gleason 3+4-7 I think he was disingenuating me towards IMRT. Is he a guy that specializes in prostates, or does he mainly do other types of cancer?  It’s possible that he feels that the 23 gram size is not within his limits of skill – in which case you sure don’t want him to do it.  But it’s possible someone else can.  You might want to check – hopefully with someone who won’t just say, "Yes I can do it" because he wants your business and doesn’t care if he hurts you in the process.

So who is the best pro closest to Philadelphia?  Yes, we’re minimizing two variable in a function. However external beam radiation is also an excellent option. it is my understanding that EBRT and brachytherapy get very similar results.

and that SI/HDR/EBRT get the best, which has to do with why I prefer that sequence.

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