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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2006

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Back Pain

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alva36@gmail.com - 07 Jan 2006 02:09 GMT
Have any of you guys suffered lower back, pelvic area or thigh pain
attributable to Zoladex and/or Casodex?
Jim - 07 Jan 2006 17:20 GMT
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

>Have any of you guys suffered lower back, pelvic area or thigh pain
>attributable to Zoladex and/or Casodex?
Clarence Crow - 07 Jan 2006 19:54 GMT
>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!



 
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alva36@gmail.com - 08 Jan 2006 11:39 GMT
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.
Steve Kramer - 09 Jan 2006 11:53 GMT
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.

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, 5/05, 10/05
PSA  .07 .05 .06 .05 .08
Non Illegitimi Carborundum

> 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
[quoted text clipped - 5 lines]
> started on the meds and had another bone scan in July - fortunately
> negative.
Brian - 08 Jan 2006 21:54 GMT
> 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.
Alan Meyer - 09 Jan 2006 05:17 GMT
> ...
> Clarence, please state what was the volume/weight of your prostate at
[quoted text clipped - 3 lines]
> 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
Brian - 11 Jan 2006 23:40 GMT
>> ...
>> Clarence, please state what was the volume/weight of your prostate at
[quoted text clipped - 10 lines]
> 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.
Clarence Crow - 09 Jan 2006 06:07 GMT
<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.


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Alan Meyer - 07 Jan 2006 23:14 GMT
> 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
 
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