I would trust very few medical oncologists, let alone family physicians,
to manage my ADT. Even the specialists ignore or mismanage the SEs; most
non-specialists would be clueless. Your husband should at the very least
be involved to this extent:
1. He should be on bone-preserving drugs if he can tolerate them.
2. He should also be trained and motivated to perform strength- and
bone-building exercises and aerobic whole-body exercise.
3. He should probably have already been treated (chest radiation) to
prevent gynaecomastia.
4. He and you should be cautioned to watch closely for the long list of
specific SEs so:
a. They won't surprise or scare you.
b. He can bring many of them to the specialist's attention quickly.
c. He and you can assess the benefit-to-risk ratio in advance and during
treatment.
5. The both of you can assess the specialist's grasp on reality by
comparing his benefit and SE awareness to the literature.
6. You two can choose among the variety of ADT regimens such a single,
double, triple, intermittent, continual, etc.
7. Who's monitoring the PSA and other measures of success to evaluate
the ratio of benefit to SEs?

Even the most advanced cases, in which ADT is almost a no-brainer, still
present dilemmas to be resolved by the patient.

I.P.

Hi Dora...Usually, before the second shot is administered, a blood
sample is drawn so that the testosterone (T) level can be measured
(some docs recommend the DHT level be measured too).  If the T level is
not below the "castrate" level (20 ng/dL or 0.694 nmol/L), then the
Lupron isn't doing its job and an alternate ADT strategy may be
required to effectively treat the PCa...Best wishes and good health, ron

Get all his blood chemistries from before the shot. Preferably going
back a few years.   Lay it all out so you and he can see if there are
any changes.

The docs don't have time (or computer software) to do this.

Also note down in a journal, ANYTHING that happens that seems odd.
You're looking for joint pain, exhaustion, confusion, tiredness, hot
flashes.  If he normally walks a couple blocks and one day notices that
he feels shakey, write that down.

Weight, appetite, how often you have sex and what it's like.

Take pictures.  I think my hair started growing in while on Lupron.
That's a minor thing.

The thing that got me was the insane thirst.  This was probably due to
elevated blood sugar, caused by the Lupron.  

-kh

From: limey113@yahoo.com (limey)

As you may remember, Henry and I are relatively new to all this.  
Perhaps
someone can answer my question.
My husband had a Lupron shot on August 29 and will get the second one on
December 29, given by the nurse.   There has been no mention of a
follow-up appointment with the urologist. Is this the norm? How often is
someone seen by the uro, to check progress?   Or is that left up to
our family doctor, who has been the one who prescribed pain medicine?
Our family doctor is the first to admit he prefers to send people to a
specialist.
Or is there nothing to be done except to wait, to see how the Lupron
works?
Happy Thanksgiving, everyone.
Dora

=======
hi dora - i think this part of the treatment flat out sucks.  

i would take my dad in for his shots and the nurse would give him the
shot and that was it.  at 1600 dollars a shot, you would think that the
doctor would at least thank him or shake his hand for making the next
payment on his lexus or something.  

this went on for years and never changed.

hope you have a better experience with it that i did.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

Hi again, Dora.

Lupron shots come in three varieties; 1 month, 3 month and 4 month.  I am on
teh 4-month dose so I see my uro every four months.  And, I get my PSA every
four months.