Taking Eligard 22.5 mg (3 mo injection in upper arm) Only side effects are
weight gain, loss of muscle strength, and nipple soreness. May will be one
year.

Good luck. BTW, The reason for Eligard is its reputation for NO hot flashes.

I actually had few if any side effects for first two or three weeks
when I started Lupron/ Casodex (150 mg) in May 04.  Then I got
progressively worst; bad head aches, fatigue, memory lapses, then those
hot flashes.  Most of these SE disipated after two to three months.
Ten months our, my only real SE is slight fatigue and hot flashes which
have deminished somewhat.  Exercise is a real resource to take
advantage to minimize SE.  My medical oncologists kept insisting that
heavy duty exercises will work and I believe they have.  Never had a
serious weight gain or breast enlargements to date.  However, I do
experience some muscle wasting and subsequent back problems due to
weakened muscles there.  I also am experiencing osteoporosis and
receiving infusions of Aredia and oral Cacitrol to offset bone mineral
loss.

Don't determine a choice of continuing or quiting after only one month.
You may want to give yourself up to 4 months to reevaluate decision to
quit.

There is literature from PCRI.org showing similar stats to percentages
of individuals with various SE you refer to.  Of interest is that fact
that most of these SE can be remedied by specific actions recommended
by Dr. Scholz.

I do not have time to search out the references I made above today, but
I will post them later tonight.

Richard fr Monterey

dx'd May 04, bPSA 13, GS 4+4, 6/12 sticks of bx pos 70-90%.  Reciving
ADT3, Chemo, IMRT and HDR.

A pattern seems to be forming in my mind that those who worked or played
hard notice the effects of ADT more markedly than the more sedentary. The
thought, is this down to emotions as well. For instance the more sedentary
have PC to cope with, which is bad enough, but can more easily carry on  a
'normal' life. However those with PC and who also have to change lifestyle
of work or play more markedly have a double whammy to cope with. And of
course those in the latter maybe more likely to come off ADT earlier. Just a
thought from newbie Ray.

On February 14, I.P. wrote:

(ka-snip) See how easy it is?

I wonder what IP did to make his medic hate him.

I bitched/whined about Zoladex and its method of injection, and was
switched to Lupron, which is injected into the buttock. Much less painful.

As I have posted, I fired my rad onc, mainly 'cuz he's an arrogant twit
and because he is ignorant of current PCa medicine.

He is the medic who prescribed Lupron.

I have just met with my med onc, who is *impressive* and who tells me
that she does not use Lupron because Medicare (and other insurers) will
not reimburse her in an amount equal to the cost to her of the
medication. !!! WTF is going on, I wonder.

Anyhoo, she does use Trelstar, which I had never heard of until today.
It is an intramuscular injection into the buttock, given monthly. The
chemical name is triptorelin pamoate. It is a LHRH agonist, as are
Lupron and Zoladex.

Unlike Lupron and Zoladex, it is intended only for monthly injections,
and if anyone has been paying attention they will know that many
insurers will not pay for injections of Lupron and Zoladex that are
given at intervals less than some multiple of calendar months. This is
contrary to the manufacturers' instructions (presumably approved by the
FDA) which are based upon weeks, not months. But it saves the bastards a
few hundred dollars per patient per year. Meanwhile, during the ten or
so days between the medically-appropriate renewal time and the time
demanded by the clerical personnel at Medicare et cetera, the patient's
testosterone and PSA can rise alarmingly.

Climbing down from my soapbox, I will answer IP as follows:

Hot flashes: yes. Mildly annoying, but not unbearable. Maybe they'll
improve, maybe not. I don't care.

Fatigue: yes. Feel tired constantly. Hit the sack @ ~1930, read for an
hour or so, sleep (minus nocturia) until ~0730. BUT: if I have something
interesting to do, such as distributing Us Too! brochures to onc and uro
offices, I get along quite well.

Depression: yes. My med onc and I have agreed that "situational
depression" is normal. IOW, in our situation, not to be depressed would
be abnormal. I've agreed to try low-dose Zoloft to help me cope.

Osteoprosis: I've posted extensively on this subject. It is *always* a
substantial risk of ADT. And it can be handled. All the patient needs is
a medic who is up to date. Or at least awake.

Um, IP mentions irritability, "brain farts" whateverthehell that is,
irritability, emotional turmoil (whatever that means), poor sleep,
nausea, diarrhea, pronounced personality alteration, breast pain as
SE's. My answer: nope, beyond what I've covered elsewhere.

Lipid elevation: Yup. Just watch diet.

Liver damage: possible. Not in my case, per regular hepatic panel tests
as recommended by the manufacturer.

Psychological stress: I don't understand IP. Who among us would NOT have
psychological stress in our situation?? Whatthehell does that have to do
with dosage of a LHRH agonist?

Upper body muscle atrophy: yup, it's possible if one fails to take steps
to address it.

Weight gain: yup, it's possible if one fails to take steps to address it.

Breast pain: and, by implication, gynecomastia. I do not believe that it
is likely unless one is using Casodex, but I may be mistaken. On Lupron,
I do not see a problem.

Arthritis and diabetes exacerbation: please define.

Libido/ED effects: I cannot respond (no pun) because I've been
profoundly impotent since cryo on 11/20/03. But, although I cannot climb
the mountain, I still can enjoy the view.

Regards,

Steve J
__
"If a man does not keep pace with his companions, perhaps it is because
he hears a different drummer. Let him step to the music which he hears,
however measured or far away."
--Henry David Thoreau

IP,

I originally responded to your "hormone survey" whereby my husband fell
into the "debilitating side effects" category and hence quit hormonal
therapy early.  I think I originally posted that he did 9 months but in
actuality it was 10 months on Lupron with severe side effects when he
decided he had enough.  Your first question was in regard to the time
scale of side effects.  To address that I have to say that at least in
my husbands case, the side effects were cumulative.  During the first
1-3 months, he still felt relatively good and had only minimal fatigue
and hot flashes.  It was truly during the 3-6 month time period on
hormones when the side effects became intolerable.  You asked if the
side effects got worse/better or what?  In my husbands case, the side
effects got worse over time.  Due to his fatigue/weakness, by the 6th
month he couldn't mow the grass anymore.  I was noticing significant
cognitive changes in him as well.  He was quite depressed and spent
most of his free time in bed.  He gained approx. 10 lbs, had breast
tenderness and an exacerbation in his arthitis.  Lets not forget those
hot flashes - he would experience approx. 20 hot flashes per day.  His
libido was nonexistant. During the 6-10 month time period on Lupron,
the side effects continued to be unrelenting and it was at that time
that we really reevaluated and decided to discontinue them and go for
IHT as needed down the road.

IP, it has been approx. 4 months since my husband discontinued the
Lupron and I am thrilled and amazed at how quickly he has rebounded.
His energy is almost back to normal, no more depression, very few hot
flashes at this point and last but not least, his libido is back.  This
is really encouraging to us because it shows that should my husband
need IHT later that maybe he will actually achieve a good QOL during
the off cycle.

In retrospect, I'm actually glad that my husband did the hormonal
therapy even if for a shorter than anticipated time period.  First and
foremost, we hope he gained some therapeutic benefit from the
treatment. Interestingly though, it has given us great insight into
hormonal therapy and exactly what to expect.  Given the prospects of
possible IHT later, somehow we don't feel so threatened by it anymore.
We now realize that he can have a heightened QOL during the off cycle
which makes it much more bearable.

It's hard to find that balance between quality and quantity.  Going
into this "nightmare", we were all about quantity but after going
through surgery, radiation and 10 months of hormones, I think quality
has become more important at this stage.  I'm glad to see that even
with all your research, you've been able to keep an open mind and I
applaud what you're doing.  I'm not sure though that one month of
hormonal therapy will be enough time to make a final determination -
you may want to give it alittle more time to assess your side effects.
Plus, we went with the monthly injections so my husband wasn't locked
into the side effects any longer than desired.

All the best to you IP.  I hope you fall into the 1/3 category without
symptoms - please keep us informed.

Sandi

Took Lupron - 1 30 day injection, 1 90 day injection.

First two weeks - no negative reaction at all.  If anything my
libido was increased.

At the end of four weeks, side effects just beginning.

At the end of 6-8 weeks, side effects in full force:

  Hot flashes.
  Reduced libido - to almost none.
  Elevated liver enzymes - enough that they gave me no more Lupron.
  Reduced energy, reduced exercise capacity.

3 months after the end, arthritic like pains in the hands - may or
may not have been due to Lupron.

I was able to overcome all of the side effects except the elevated
liver enzymes.  I tried giving up ibuprofen, alcohol, aspirin, but with
no effect on the liver.  Only when the Lupron wore off did the liver
enzymes return to normal.

Hot flashes:
  It was winter, just kept the house cool.

Libido:
  My wife and I had to work to get me started, but once started
  I was able to get into it and continue.  We didn't have sex as
  often, but we didn't give it up entirely.

Energy:
  My exercise capacity went down, but I kept exercising at some
  level throughout the treatment.  I always maintained enough
  energy for daily living.  It was only the hard exercise that I had
  to cut back.  I did get a bit more sleep than usual and that also
  helped.

Arthritic symptoms:
  I still have these, but they are entirely controlled with exercise
  and stretching.  I do massive amounts of both for my hands and
  have virtually eliminated pain and stiffness.

As for depression and mood swings, I don't believe I had any
due to the Lupron.  I certainly had some due to having cancer
and wondering if I was going to die before my time, but I don't
think the Lupron exacerbated it for me.  As others have said,
it would take a pretty extraordinary person not to get emotionally
upset about having cancer.

I didn't notice any "brain farts", or at least not more than the usual
number I am afflicted with.

Bottom line:
  I didn't like HT, but I will do it again if the need arises.  I found
  it disagreeable but very manageable.  If I thought 1) it would
  increase the chance for a cure or 2) prolong my life, I would
  do it again.

   Alan

I.P.,

I was very surprised to see that you went ahead with ADT after all you have
said before.  My own thought was that maybe you were over analyzing the
problem, but we tend to do that.  As to the side effects, you can read and
talk to all you want, but the effects will be different for different
people. You will have to see how your effects come on and how well you
tolerate them. I will give you a brief description of what happened to me.
I definitely knew when the effects started. About three weeks after the
injection, the thought of and desire for sex went way south.  It was a
strange feeling to suddenly have NO interest at all (I was 49 year old at
the time). The hot flashes started about the fourth week. The worst was the
mood swings. I could go from feeling fine to major depressed in a matter of
seconds. The cancer and the RRP do enough to our mental state, but I truly
think that the Lupron made it worse. I warned my partner that if I had fits
of anger and said things that were vicious, to remember that sometimes the
drug is talking, not me.  And I did have fits of anger that I later had to
apologize for. I did not feel the other effects until after several months
of ADT.  I kept up an exercise routine, but after about six months it was
very difficult due to a feeling of tiredness and weakness. After about one
year is when the fatigue set in really bad.  The fatigue got worse with each
passing month until I reached the point that I really could not do anything.
The fatigue was the biggest reason I quit ADT after being on it for 20
months. Each person will see different effects.  Hormones are all through
you body, and can effect any part thereof.  I had a real change in my vision
after about six months of ADT.  The eye doctor was surprised at the amount
of change from the last exam.  I think it was from the ADT, but no one can
prove that.  I developed vertigo when on ADT.  Could not even walk out on to
a six floor balcony at friends condo.

The point is, even if we all have some similar stories to tell, we are all
different. You will have to see for yourself how you endure. I really don't
think that one thirty day shot is a very fair trial, and is really not going
to do you any good as to fighting any cancer you may still have present.
You really should make a longer commitment now that you have started.  I
would think that 90 days would be an absolute minimum for you to stay with
it.  Remember, for the most part, the side effects do go away when the ADT
is stopped.

Wishing you the best of luck, and time will tell how you respond.

Later,

Dale P
Denver, CO