DEPOPROVERA

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azjim - 02 Aug 2005 19:08 GMT

Subject is "hot flashes" (mine from LUPRON). Has anyone defined "hot
flashes"? Description of my experience follows. If yours is similar, or
dissimilar, your description should help. Purpose is to have some
assurance that what is experienced is most probably a drug side effect,
and not something else, about which "you never know" applies:

A sensation that takes over your body. You feel if it doesn't stop
(which it does in a matter of approximately 1/2 to 3 minutes for me, as
it winds down and goes away), something possibly cataclysmic is going
to happen. If you have ever had a high fever, perhaps comparably it
feels more like that than anything else, although perhaps not exactly.
With mine I experience very noticeable sensations broadly in my lower
legs and forearms, like pins and needles, but not quite, sort of a
stabbing pain, but not quite.

With that attempt at a description, my main purpose is to solicit the
experiences of any others who have been given "DEPOPROVERA" to
alleviate hot flash symptoms. Am trying to evaluate the wisdom of
having DEPOPROVERA prescribed. Would appreciate feedback. Thank you.

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Stephen Jordan - 02 Aug 2005 21:51 GMT

On August 2, azjim wrote, regarding hot flashes/flushes:

(snip)

This is a well-recognized SE of ADT with any of the LHRH agonists, Zoladex,
Lupron or Trelstar.

The sensations azjim describes are very similar to mine. They have
increased since I switched from Lupron to Trelstar -- because my med onc
sez that Medicare won't fully reimburse the cost of Lupron. Hmmm.

> ......................................................... my main purpose is to solicit the
> experiences of any others who have been given "DEPOPROVERA" to
> alleviate hot flash symptoms. Am trying to evaluate the wisdom of
> having DEPOPROVERA prescribed. Would appreciate feedback. Thank you.

This Thursday, I'll meet with my PCP in part to discuss tx of the hot
flushes with either Depo-provera (medroxyprogesterone) or Megace (megestrol
acetate). Why my PCP instead of my med onc? She sez that Medicare won't
reimburse the cost of Depo-provera, either. I do know that it was not
approved as of several years ago, but though that that had changed.

Her PA, without discussing it with me, prescribed Bellergal-S, which
contains belladonna and phenobarbital. I refused to take it. BTW, this is
an example of why we must take charge of our cases. I looked it up on
RxList and decided that it was not for me.

Anyhow, to the point: both Depo-provera and Megace have good records in
relieving hot flushes.

Here are two peer-reviewed articles:

Re: Depo-provera

Langenstroer P et al: Parenteral medroxyprogesterone for the management of
luteinizing hormone releasing hormone induced hot flashes in men with
advanced prostate cancer. J Urol. 2005 Aug;174(2):642-5 PMID: 16006929

Re: Megace

Loprinzi CL et al: Megestrol acetate for the prevention of hot flashes.
NEJM 1994 Aug; 331:347-352 PMID: 8028614

Couple comments on Megace. It can increase appetite. Also, there is an
article in the literature that has caused some folks, including Mayo, to
caution that it may increase PSA. That article (PMID: 10219363) was
published in the April 1999 issue of Southern Medical Journal, and
describes a case from LSU involving *one man* whose PSA rose after starting
Megace and declined when it was stopped. One man six years ago, who
evidently suffered no lasting adverse effects. I'm not impressed. Sounds
ideopathic to me.

Since I've already gained weight due to the ADT, I think I'll go with
Depo-Provera if I can get it.

If azjim looks up the articles on PubMed at
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi he will find all that he
wishes to know.

Regards,

Steve J

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azjim - 04 Aug 2005 21:58 GMT

STEVE:

THANKS. FYI I HAVE HAD NO PROBLEM WITH MEDICARE REIMBURSEMENT FOR
LUPRON. PERHAPS THERE IS A QUANTITY LIMITATION, OR WHATEVER. LOOKING
BACK, I NOTICED I WAS GIVEN MEGESTROL FOR HOT FLASHES ONCE. DIDN'T SEEM
TO HAVE ANY EFFECT, HOWEVER, AND WAS CANCELLED.

AZJIM

> On August 2, azjim wrote, regarding hot flashes/flushes:
>
[quoted text clipped - 58 lines]
>
> Steve J

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Steve Kramer - 06 Aug 2005 12:44 GMT

I look at a thermometer and see if it's really that hot in the room.

Signature

PSA 16 10/17/2000 @ 46
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
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA .07 .05 .06 .05
non Illegitimi carborundum

> Subject is "hot flashes" (mine from LUPRON). Has anyone defined "hot
> flashes"? Description of my experience follows. If yours is similar, or
[quoted text clipped - 15 lines]
> alleviate hot flash symptoms. Am trying to evaluate the wisdom of
> having DEPOPROVERA prescribed. Would appreciate feedback. Thank you.

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Ben - 06 Aug 2005 13:26 GMT

I'm wearing out my shirts pulling them on and off.

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