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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2006casodex, perineural invasion, and other new big words
Hi all and God Bless y'all, I feel like a mooch on this site, always asking and never offering information. there is so much involved in this disease I never imagined. After the Dr. told me biopsies were positive and gave me the readout of the Gleason report and all, he gave me a prescription for "casodex". Also 9 of the 12 biopsies showed a phrase "perineural invasion". I looked it up and it said something about the cancer cells attaching to a nerve lining in the prostate and following the nerve out of the prostate sack. Then it lost me and I'm not sure if I got the right idea. Yesterday they gave me two iv's of some radioactive dye and scanned the organs, then the bones. I got home just worn plumb out. I've been on the casodex two days. The bone pain in my hip and leg has really intensified in the last 4-5 days. I'm not a mental giant, but always could read very well. Lately I can't read two paragraphs and tell you what it said, is this normal? Is the tiredness due to casodex or radioactive dye? On a recent post I read that the Dr.s don't give pain killers much anymore. Is this true? I'm pretty tough but I can see where I might be headed into a whole new realm of pain. What, exactly does casodex do? Jim, posted that he had taken it with volatrex. On the med info the pharmacists put with the script, it said that "infrequently" ,when taken alone, sometimes it had the unpleasant side effect of "sudden death". I understood that when I read it. I sure appeciate you guys, and I love humor and love to laugh. You cannot offend me. So any feedback of any type is welcome. My own wit seems to have left with my reading and comprhension abilities. Hopefully it'll come back. Some things here people ask. 1. I'm 53 yrs. old 2. my psa 3 weeks ago was 39.8 (first reading) 3.All 12 biopsies came back 7,888,999999, 10 10 on the Gleason scale. David 3. Hello Dave, Here is a link that has allot of information regarding our disease. http://www.prostatecancerfoundation.org Here is another link that defines Casodex, I use this site to research all of the drugs that I am taking. http://www.drugs.com/mtm/c/casodex.html I was diagnosed last July with advanced metastatic prostate cancer. I started with at PSA of 1506 and am now down to 5. I did allot of research on this disease and was able to find a clinic that specializes in treating Prostate cancer. Visit the above web site I believe there is information that would help educate you. Angel Welcome, Angel. Has Casodex been your only treatment to date?  SignaturePSA 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, 2/06 PSA .07 .05 .06 .09 .08 .132 Non Illegitimi Carborundum > Hello Dave, > [quoted text clipped - 14 lines] > > Angel David, this is going to be very short and elemental because it can get really complicated in a hurry. Casodex is the brand name for bicaltumide, which is an anti-androgen that prevents testosterone (T) and DHT from getting into PCa cells. It is one prong of the so-called triple androgen blockade or 3ADT, HT, or whatever you want to call it. The others are an LHRH agonist like Lupron that actually results in less production of T, and a 5-alpha reductase inhibitor like Proscar that prevents T from being converted to DHT. When your doctor saw what you were dealing w/, and knowing it would be awhile before you settled on a primary Tx, he wanted to get you on something immediately to try to preserve the status quo. Casodex has fewer SEs than Lupron so he chose that. It's like putting a clamp on a split radiator hose until you can get to the repair shop. If I may ask, how did you get into this predicament? You evidently had PCa for years and only found out about it through serendipity. Bill Denton RP 2/12/02 PSA .67 Memphis Bill, thanks for the reply. In answer to your question. I don't know how I got into this....I woke up last night and the question on my mind was, "What in the hell happpened?" I had a hernia repair, and a colonoscopy at the same time. He found a growth in im colon larger than a golf ball. The plan was to take it out later and send it off. He also suggested seeing a urologist. I've been driving a truck about 4 years and was a cowboy/rancher for 28 years before that. A lot of time in the saddle. Both hard on the prostate I'm told. Anyhow, I had trouble urinating at times and was not suprised giving my lifestyle. It usually cleared up. The trucking company I work for gives regular and random UA's. Theylook for drugs as well as blood and sugar. I was always clean. The uro did a dre and I was so tender it nearly put me to my knees. This is early Feb. So he ran psa and started me on flomax and Levaquin. The psa came back 39.8. So he did biopsies and here I am. My bladder came up clean. He looked. Thnaks again Bill David David, what I meant was how you had PCa and off-scale PSA for years and it was never detected? Were you like me - my first PSA was at 51 (33) and my first DRE shortly thereafter? On long drives I had felt like I was sitting on a marble but I ignored it. After RP I realized that my stream had been weak - it happened so slowly over the years trhat I did not notice it. Bill Denton RP 2/12/02 PSA .67 Memphis Bill, yes, you pretty well nailed it. I thought hemorroids, was uniformed, denial....it won't happen to me etc. What procedures have you had done Bill? thanks for reply David Despite my high PSA I went ahead w/ RP after a negative bone scan (not that it was likely to show anything). I was 3+4 w/ seminal vesicle involvement on one side and I had detectable PSA w/i 8 mos. Because of the SVI I have foregone RT because I believe I have systemic disease. After 4 years my last PSA was .67 and is in an acceptably slow rise. At some point it will take off and I'll do HT or maybe a clinical trial. Bill Denton RP 2/12/02 PSA .67 Memphis Hello Steve, After diagnosis, I was immediately placed on Casodex then given Lupron. 3 months later I reached Hormone Refractory. I have just completed 6 rounds of Taxotere at 3 week intervals along with Zometa. My Doctor switched me from Casodex to Nilandron which is similar to Casodex. I am now about to receive a single dose of Quadramet which is radiation given by injection this week. > I feel like a mooch on this site, always asking and never offering > information. Nonsense! I've been here for almost 4 years and just asked again for information last night. Worry about getting through your current crisis. Then you can repay those here, especially those that follow you. > Yesterday they gave me two iv's of some radioactive dye and scanned the > organs, then the bones. I got home just worn plumb out. I've been on > the casodex two days. The bone pain in my hip and leg has really > intensified in the last 4-5 days. Fatigue might just be nerves. Might even be depression. But, I'm guessing it is the lack of sleep to which you earlier eluded. If the bone pain is cancer (remember we're still praying it is not), the increase may be due to a testosterone bounce common at the beginning of hormone treatment (HT). However, it may _seem_ more painful due to the fatigue. Give it a week or two and I'll wager you pain subsides some regardless as to whether it is cancer. > I'm not a mental giant, but always could read very well. Lately I can't > read two paragraphs and tell you what it said, is this normal? Is the > tiredness due to casodex or radioactive dye? It sounds like a side effect (SE) of Casodex, but I cannot imagine it has hit you already. I didn't notice memory issues until months later. > On a recent post I read that the Dr.s don't give pain killers much > anymore. Is this true? I'm pretty tough but I can see where I might be > headed into a whole new realm of pain. More nonsense! There has never been a better time for a painful ailment. The available pain meds are much better than they ever have been. > What, exactly does casodex do? Casodex is an Androgen Deprivation Therapy (ADT), sometimes called hormone treatment (HT). Extremely briefly, is starves prostate cancer (PCa) of testosterone. The PCa cells then die or go dormant and any masses of PCa (tumors) shrink. It will decrease the size of the mass in your prostate in anticipation of possible surgery and, if it's in your bone, the mass in your bone. It is not a cure, but it usually works very quickly to reduce masses and pains due to masses. > I sure appeciate you guys, and I love humor and love to laugh. You > cannot offend me. So any feedback of any type is welcome. My own wit > seems to have left with my reading and comprhension abilities. David, I think you have to consider that some of your symptoms to which you are trying to attribute to Casodex are also common with depression. And, depression, especially initial, short term or periodic is common among cancer patients. You've been told you might die. That was quickly followed by being told you might have to be gutted. Then that your biopsy results are dire. And all of this in a very short time, near to the prime of your life, at a time when you were just getting used to planning for your retirement. I recommend three sessions with a psychiatrist. If nothing else, talking will help. SignaturePSA 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, 2/06 PSA .07 .05 .06 .09 .08 .132 Non Illegitimi Carborundum |
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