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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2007Are there ways to overcome the sexual side effects of Casodex and Lupron horme treatments?
Hello, I would like to know how to increase Libido and obtain erections and ejaculation in the following circumstances:" Also, will I now be infertile (no viable sperm) taking this new med? I just started Casodex and in a week will get a shot of Lupron. This is because my PSA score has been slowly increasing and is now at ELEVEN (11), five years after surgery to remove cancerous prostate, . Right after the operation, my PSA was ZERO (0) and I thought the doctor said "we got it all" meaning the cancer had not spread and all the cancer cells were removed. Now, with PCA going up, bone and CD scans normal, the urologist wants me to get a Lupron injection every three months for life. . That is to reduce the testosterone level to ZERO, and keep it there, with the expected effect of cutting off the supply of T to the cancer cells and stopping the increased PCA and possible recurrance of the prostate cancer somewhere new in my body. I did not want to take the Lupron, but the urologist said if I do not, I will die within five years, probably from bone cancer.Since I am 71 and otherwise in good health, I finally decided to take the extra years even though an oncologist said it was unneccessary to treat the rising PSA score. The trouble is that I am single (widower) and would like a relationship that includes sex. Lupron is supposed to kill off any desire to have sex, however. That, will be added to my current problems of ED, low testosterone level, overheating, fatigue, muscle weekness and depression). I view having NO INTEREST or even low interest in sex to be unacceptable, although I may be forced to accept the treatment in order to remain somewhat alive. Well, if anyone has had luck with raising libido in the face of falling Testosterone and ED problem and then having even "fair" sex. I am all ears! Thank you l OldDog, First of all I would like to suggest that you find a medical oncologist who specializes in prostate cancer. He will be better equipped to treat you than a urologist and may have a plan for you that is better than getting on Lupron for the rest of your life. Your PSA is rising slowly - which is far better than if it is rising fast. You may be a candidate for intermittent hormone therapy with off periods between treatments. You may also be a candidate for a milder form of hormone therapy, such as using Avodart to prolong off periods, possibly for years, with much less effect on libido. I don't know if these are good ideas, or good for you, but you should consult a specialist because there's a good chance that your urologist doesn't know either. Now as to the hard questions: > ... I view having NO INTEREST or even low > interest in sex to be unacceptable, although I may be forced to accept > the treatment in order to remain somewhat alive. Unfortunately, the loss of your libido may well make a lack of interest in sex perfectly acceptable to you. That's what loss of libido means - not just that you have trouble getting an erection, but that you don't particularly want one and have a little trouble remembering why you ever did. Still, I hear you. Psychologically, losing my libido was still a problem for me. One doctor told me I wouldn't be able to have sex and I wouldn't care. But both statements turned out not to be true. I did care and, to my surprise, I was able to have sex. I did not have sex often while I was on Lupron (I'm off it now, it was a temporary treatment for me) but I did try from time to time. I did it with no particular interest, believing that I had to try for my wife's sake. Then, to my great surprise, 10 or 15 minutes into the process, as my wife became more and more aroused, I found that I became quite aroused also and was able to have sex in the usual way and with all the same satisfaction. Sex seems to have a strong psychological component to it that, at least some of the time, is capable of overriding the lack of hormones. Alan > Hello, > I would like to know how to increase Libido and obtain erections and [quoted text clipped - 32 lines] > falling Testosterone and ED problem and then having even "fair" sex. I > am all ears! You and the other hundreds of thousands of guys on ADT. I'm sure you'll hear about it when they find a solution that suppresses PC without leaving us . . . hanging. But consider a few facts that may give you some feeling of control even if you don't find your solution. ADT is a choice at any stage of our lives, *especially" before we have significant symptoms from mets. Many oncologists -- including yours -- advise we wait until symptomatic to begin ADT, because ADT SEs are sometimes worse than the symptoms, because ADT adds only months of lifespan to the average patient, and because some studies imply that ADT may sometimes even hasten and exacerbate the PC's return. In favor of ADT in your case is the high PSA and the fact that you can always refuse or modify further ADT if your own SEs are too severe, and hope your testosterone production resumes. Your question makes me wonder how much research you've done. Have you read a few hundred of the many thousands of hits you will get from Googling Casodex, Lupron, Proscar, etc.? Can you write a couple of informed pages on the purposes, functions, benefits, short and long term side effects, and studies of ADT, including IADT, ADT1, ADT2, and ADT3? It took me hundreds of hours to learn enough about ADT to make what I consider to be a valid decision for or against committing to ADT; it is often a tougher decision than choosing one's initial treatment. BTW, your surgeon should have made it crystal clear that "getting it all" means only that the guys in the pathology lab could not see any cancer at the edges of your removed prostate. They have no way to detect the millions of PC cells already swirling around your body in and from your bloodstream. I.P. On January 27, Mikey Freely bloviated: > ......ADT adds only months of lifespan to the average patient.... I know he won't provide evidence because he cannot, but I have a duty to point out that this makes no sense at all. It's typical chicken-little lawn fertilizer from a man who declined ADT and seems to feel that he must, time and time again, try to justify that decision. Regards, Steve J -- A lying bastard, according to this fellow who excoriates others for posting what he claims are ad hominem attacks (a phrase that he stole from me). > > ......ADT adds only months of lifespan to the average patient....I know he won't provide evidence because he cannot, but I have a duty to > point out that this makes no sense at all. > > It's typical chicken-little lawn fertilizer from a man who declined ADT > and seems to feel that he must, time and time again, try to justify that > decision. There may be a bunch of wishful thinking going on but I suspect there is a slight bit of truth (or half-truth) in that few months statement. I vaguely recalling that in some advanced cancers, there's nothing that seems to work. I have no idea how common that is or if it's because the final months of pain drives some poor unfortunate to the docs, they diagnose advanced prostate cancer, PSA 800, give him a shot but by then it's too late. It woulda killed him in 14 months, they stretch it to 18. My sense is that most guys are detected early now, many early enough that the radiation or surgery blasts the cancer and reduces the cell count to the point that random mutations would take centuries to reestablish prostate cancer. About 10 percent aren't that lucky and their PSA starts rising. Of those, the cancer can still be treated well by hormones/anti- testosterone treatment. 5 years, 10, 15? Who knows. A lunatic in an SUV yapping on their cell fone might get them first. We're what? 55, 65, 70? Can you work the numbers for a stroke or heart attack? Give me 10 years and off Lupron half that time and I'll do my part to keep the elderly women of America smiling. -kh I'll do the job for 2 guys, where's that Vitamin-V? On January 27, kh responded to me. in pertinent part: > There may be a bunch of wishful thinking going on but I suspect there > is a slight bit of truth (or half-truth) in that few months statement. [quoted text clipped - 5 lines] > but by then it's too late. It woulda killed him in 14 months, they > stretch it to 18. I suspect that kh and Mikey Freely have conflated ADT and chemotherapy. It is the latter, particularly docetaxol (Taxotere), that was shown in the original studies on average to extend life by those months. As my med onc has pointed out, those brave and selfless men were "on their last legs." They were far advanced and had no hope. What they have told us is that chemo can succeed; and if resorted to early enough, can extend life substantially. Let us never forget. All honor to them. We stand on their shoulders. Regards, Steve J "No man is an Island, entire of itself; every man is a piece of the Continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friends or of thine own were; any man's death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the bell tolls; It tolls for thee." -- John Donne >> ......ADT adds only months of lifespan to the average patient....I >> know he won't provide evidence because he cannot, but I have a duty >> to point out that this makes no sense at all. > There may be a bunch of wishful thinking going on but I suspect there > is a slight bit of truth (or half-truth) in that few months statement. I don't think you were here then, kh, but Steve knows and the archives prove that I provided many (roughly two dozen, at least) extensive and authoritative references, including metastudies thereof, to support an average of 6-8 months (I didn't say "few"; you added that) of life extension for early adjuvant ADT. My statements and references were reviewed with concurrence by this forum and by a team of oncologists in many specialties, and the best other forum regulars have come up with since then (that was 2 years ago) is an average of a little over a year in certain circumstances from one more recent study. Steve inexplicably regurgitates his deliberate lie (that I won't/can't provide evidence) every few months in the hopes some of the newbies will succumb to it, and every 2nd or 3rd time he does so, I bother typing this response as a reality check for the newbies here. Yes, the variations about that 6-8 month figure are wide, ranging from years on one edge of the bell curve to apparently hastened (sooner than expected) and more advanced (higher Gleason grade) recurrence attributed to the ADT on the other edge, raising a big question: which side of the bell curve will *your* PC follow? Odds are it will approximate the average value; I welcome any evidence to the contrary, but the closest I have seen to that was the study literally hinting at a 14-month-average benefit in limited circumstances, discussed at length here last year. I.P. On January 27, MikeFreely wrote: Some blather that he represents as a response to my lies. But he produces no evidence. And continues his harmful misrepresentations. It's no fun to oppose him and find myself subjected to his attacks, but I reckon I'm elected to protect the truth. As I've pointed out before, he's glib, but that is no substitute for wisdom. Pitiful. Regards, Steve J Old Dog.... I have been on Lupron/Eligard since May 2004. I also have not seen an Urologist since my first injection. I do see a Medical Oncologist that specializes in PCa. I see a research MO that has been in academia for 27 years and is not in private practice per se. My testosterone level is at 1.0. I have what is considered Advanced Prostate Cancer. They tell me that I am most unusual and rare in that I still have erections. I believe that the whole process is mental. Good luck and keep your mind active. > Hello, > I would like to know how to increase Libido and obtain erections and [quoted text clipped - 35 lines] > Thank you > l > Hello, > I would like to know how to increase Libido and obtain erections and > ejaculation in the following circumstances:" > Also, will I now be infertile (no viable sperm) taking this new med? Welcome to the newsgroup, George. I am sorry to hear that after 5 years of no PSA detected, you struck out. I imagine it is as big a kick in the balls as when you first heard, "you have cancer." Testosterone is a very important ingredient to libido. If you kill the T, you reduce the libido. Often, you kill the libido. When I began taking Lupron, my nearly useless member became almost completely useless. I started looking at Shania as a great singer and found Rachel Welch has an ugly belly button. Just for the hell of it, I checked to see if Willie still worked, and though unsatisfying, it did. But, now that I'm on Casodex full time, I just don't try anymore. The good news is that if you are interested in a sexual relationship for YOU, there isn't a problem, because you won't care anymore. However, if you are interested in assisting a young lady to Nirvana, you'll probably have to improvise, adapt and overcome.  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, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum > ... However, if you > are interested in assisting a young lady to Nirvana, you'll probably have to > improvise, adapt and overcome. http://www.foxnews.com/story/0,2933,248224,00.html Penis Spray May Block Premature Ejaculation Monday , January 29, 2007 By Daniel DeNoon An anesthetic spray more than doubles the "lasting" time for men with premature ejaculation, according to a study by the company that makes the experimental spray. The metered-dose, aerosol spray is a mixture of the anesthetics lidocaine and prilocaine. It is spritzed onto the tip of the penis 15 minutes before sex. Before using the spray, the 54 heterosexual men in the study ejaculated, on average, one minute after vaginal penetration. In the test, on four occasions, half the men used the anesthetic spray 15 minutes before sex, the other half a placebo with no active ingredients. The men or their partners used a stopwatch to measure the time from vaginal penetration to ejaculation. The results: --Lasting time increased to two minutes or more for 55 percent of the men who got the spray and 35 percent of the men who got the placebo. --Lasting time increased to three minutes or more for 40 percent of the men who got the spray and 13 percent of the men who got the placebo. --Lasting time increased to four minutes or more for 20 percent of the men who got the spray and 13 percent of the men who got the placebo. --On average, men who got the spray lasted 2.4 times longer than those who got the placebo. Premature ejaculation isn't defined by a specific time until ejaculation. According to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), premature ejaculation is "persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it." About 70 percent of men who used the spray and just under 50 percent of the men who used the placebo said they had longer time to ejaculation. About 60 percent of the female partners of men who used the spray, and about 30 percent of the partners of the men who used the placebo, said the men had better control over their ejaculation. The spray is called TEMPE -- topical eutectic mixture for premature ejaculation -- by manufacturer Plethora Solutions Ltd. London, which funded the study. It is not yet available on the market. "TEMPE 'as required' has the potential to offer a convenient, novel treatment option for men with premature ejaculation," conclude researchers Wallace C. Dinsmore, MD, of Royal Victoria Hospital, Belfast, Northern Ireland, and colleagues. The spray had few side effects. Four of the 26 men who used TEMPE did report side effects. Three had numbness of the penis, and one reported erectile dysfunction. Only one of the men's sex partners reported a side effect: a mild burning sensation during intercourse. Emla, from AstraZeneca, is also a mixture of lidocaine and prilocaine. It comes in a cream formulation and must be used with a condom. TEMPE does not require condom use. The study appears in the February issue of the urology journal BJU International. ================ This gets me. Is this true? "... men in the study ejaculated, on average, one minute after vaginal penetration." One minute? I'm sure it happens because women have told me about encounters with 60 second wonders. A couple guys have admitted to being quick on the draw. I'm doing a little better. Lasting about 5 minutes but I find I have to stop and sometimes I lose the erection. Drat. Before the prostate cancer, I could go and go, it was great. Now I manage a better-than-stuffable erection without pills but it takes thinking AND rubbing. The days of an erection at a stray thought are over. Even with Vitamin-V, everything has to be "right" or not much comes up. My main complaint is that the orgasms aren't that good. -kh
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