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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2007Hormone Therapy
My father is currently undergoing radiation and hormone therapy. Has anybody on here had any problems with the hormone therapy? It's really putting my father in a lot of pain. Almost to the point he wants to stop. He had his 5th injection yesterday and I was shocked to see the hole in his stomach from it! It gives him terrible burning in the stomach and just physically wears him out. After spending 5 minutes at my house he was almost in tears asking my mother to take him home. It's strange because he has such a huge tolerance for pain after surgeries for other problems. I haven't seen him like this since he had his prostate removed back in October. You can talk with the Oncologist. Remember that hormone therapy affects the entire body in a way. It slows if not stops testosterone production and that in itself produces many ailments in men in differing ways. I remember I had Lupron Depot, and I had hot flashes, sweating/ and felt very lethargic, and lost a lot of strength. I was not myself........ Radiation Therapy can also cause many problems with lower bodily functions. Talk with the Dr. and share your concerns... John Loomis. Wish your father the best. > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's [quoted text clipped - 6 lines] > after surgeries for other problems. I haven't seen him like this > since he had his prostate removed back in October. > My father is currently undergoing radiation and hormone therapy. > Has anybody on here had any problems with the hormone therapy? I had difficulty breathing, short of breath. Couldn't walk half a block without collapsing. My legs ached. My arms were sore. Then I discovered that HT can affect the bones much like arthritis does. I have ankylosing spondylitis, and that is one of the side effects described for HT. Now I'm due for a hip replacement in what was a "good" hip before HT. And of course the urologist never explained all of this before starting the treatment. On March 6, lalevesque wrote: > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's > really putting my father in a lot of pain. Almost to the point he > wants to stop. He had his 5th injection yesterday and I was shocked > to see the hole in his stomach from it! It gives him terrible burning > in the stomach and just physically wears him out. This appears to be a problem with type and location of injection, not necessarily side effects (SEs) of the drug used for ADT (androgen deprivation therapy). The only ADT med I know of that is injected into the lower abdomen is Zoladex. It can be painful. There are two possible solutions: (1) To have an anesthetic injection before the Zoladex, Lidocaine, for example. (2) To insist that another med be used. Two that come to mind are Lupron and Trelstar, which are injected into the buttock. It is time to take charge and make some changes. Information on SEs such as hot flushes and how to treat them is available on the authoritative website of the Prostate Cancer Research Institute at: http://prostate-cancer.org/index.html Go to the section "Androgen Deprivation Syndrome." FWIW, I fired a medic who knew nothing about SEs of ADT and did not care to learn. There is no excuse for inflicting what almost amounts to torment on a patient, especially when it is so easily avoided -- if the medic cares. Regards, Steve J "'MD' does not mean 'Medical Deity.'" -- Stephen B. Strum, MD > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's [quoted text clipped - 6 lines] > after surgeries for other problems. I haven't seen him like this > since he had his prostate removed back in October. It's not clear to us whether you're well aware of the SE list and its treatment and are asking just about the pain, or are uninformed about the whole SE scene. HT (actually ADT) has a long list of mild to horrendous side effects (SEs), each occurring with different likelihoods (from a few percent to virtually guaranteed) and severities (from hassles to deaths). Some can be mitigated by other drugs. But of all those SEs, lasting pain at the injection site is a new one on me. Which begs the question, "Did his oncologist discuss the SEs and their prevention and treatment at great length?" If not, it's time to demand proper treatment, which may or may not be available from this doctor. I.P. On Mar 6, 10:10 am, "laleves...@gmail.com" <laleves...@gmail.com> wrote: > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's [quoted text clipped - 6 lines] > after surgeries for other problems. I haven't seen him like this > since he had his prostate removed back in October. I would like to add one piece of information to the replies you have already received. Hormone therapy plus radiation can be used for two different purposes. At an early stage of the cancer it can be used to try to cure the cancer. The radiation is delivered to the prostate and the hormone therapy is used to reinforce the effects of the radiation, making the likelihood of a cure greater. If that is what your father is receiving, then he can consider discontinuing the hormone therapy. Some studies (though not all) indicate that the hormone therapy is most useful before and during radiation and may be discontinued some time after radiation is complete. The other possible use of HT and radiation is to manage advanced metatstatic cancer. In that case the radiation is usually administered to the bones, not the prostate. In that case it may be more dangerous to stop HT. However, as Steve Jordan said, there are other types of HT that do not require an injection in the stomach. I had a 30 day Lupron injection in the arm and a 90 day injection in the buttocks. Each injection site was sore for a few days, but there was no serious pain. As Steve suggested, your Dad may want to consult with another doctor and get a second opinion about whether and how to administer HT. The doctor should be a medical oncologist specializing in prostate cancer, not a radiation oncologist or urologist. Best of luck. Alan > On Mar 6, 10:10 am, "laleves...@gmail.com" <laleves...@gmail.com> > wrote: [quoted text clipped - 12 lines] > I would like to add one piece of information to the replies you > have already received. And I would like to ask one or two questions (as the wife of a man who had a year of these injections).......what in hell is he using to inject him with??? And why is he getting them once a month?? These shots are normally given every 3 months.....not every month. My husband had a bruise and a slight bit of bleeding, but he and I do not clot well. NEVER have I seen a "hole" in his abdomen......and I am sure the others on here are a bit baffled as well. I don't know who the doctor is that is giving these shots, but please go to a medical oncologist for them. Perhaps he could be allergic to something in the shot.....perhaps the doctor doesn't know how to give them properly and is causing him undue agony. And for heaven's sake, get freezing first. You can buy a patch at the pharmacy that will numb the area as well. Heather My husband has a feeling of "tiredness" since his shot in January. He gets another one in May from his urologist. shirleyann > My husband has a feeling of "tiredness" since his shot in January. > > He gets another one in May from his urologist. > > shirleyann I believe that loss of energy is very common. Some men have had it very severely, others mildly. I was in very good shape before beginning radiation and hormone therapy. When pushing myself hard, I could run four miles in 36 minutes - not good for a real runner, but not bad for an aging schlemiel like me. By the end of my radiation, and while still under hormone therapy, by pushing myself very hard I could just make one mile in 11 minutes and then had to quit. However, I never felt bad in daily life. I think the reason was that, being in pretty good shape, I had a lot of reserve energy. I lost a lot of that reserve during treatment, but still had more than enough left for daily life. I recommend that your husband try to fight the tiredness by 1) getting extra sleep each night, or a little nap each day, and 2) maintaining an exercise program, doing as much as he can reasonably do. This won't solve the problem but I think it's likely to make it a lot more bearable and keep it from getting worse. Alan > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's [quoted text clipped - 6 lines] > after surgeries for other problems. I haven't seen him like this > since he had his prostate removed back in October. There are several who find HT intolerable, but I never heard any complain of the symptoms that he is experiencing, other than being wore out.. Furthermore, shots in the stomach are unusual. My Lupron shots are in the butt and Casodex is oral. What is he on? And finally, it would be very unusual to have an prestatectomy in October and other treatments so soon after. Can you fill in some details.  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, <0.05 Non Illegitimi Carborundum >> My father is currently undergoing radiation and hormone therapy. Has > Furthermore, shots in the stomach are unusual. My Lupron shots are in > the butt and Casodex is oral. What is he on? <<<< Steve....Zoladex is injected in the abdomen, either 2 inches above the waist, or about 2 inches below. The first one Ron had was also injected in the same place, but darned if I can remember the name of it. I don't think you use it in the US. But it was the same as Lupron or Zoladex. Heather >>> My father is currently undergoing radiation and hormone therapy. Has > [quoted text clipped - 5 lines] > in the same place, but darned if I can remember the name of it. I don't > think you use it in the US. But it was the same as Lupron or Zoladex. Thanks, Heather. But, even more curious. Why ADT3 so soon after RP. Something just don't make sense. 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, <0.05 Non Illegitimi Carborundum My Hubby had his shot in the abdomen below his waist. It was frozen a bit before and Hubby said he felt hardly any pain. This was done at his urologist office. He does not get another HT shot until 4 months later, which will be May of this year and that will be after the radiation seed implant. He still feels tired but goes to the gym 3 times a week. shirleyann > My Hubby had his shot in the abdomen below his waist. It was frozen a > bit before and Hubby said he felt hardly any pain. [quoted text clipped - 4 lines] > > He still feels tired but goes to the gym 3 times a week. Good for him! Sometime after the seed implant he should be able to discontinue the HT. Opinions vary on how long it should be continued. Some doctors prescribe it for 6 months, some for 1 year, some for 2 and some for 3. Personally, I didn't like HT and I had some dangerous liver problems that appeared to be associated with it, so mine was discontinued after 4 months. Alan My husband dreads another HT so I told him to refuse it for awhile. He just started Flomax -seed implant to be done on 3/20. Sandoz (methylprednisolone) 4 MG, to start the night before the seed implant. The pills are to be 6 taken days after too. The day after the implant he gets a cat scan by his oncologist at the Cancer Center in our town. He is very stressed and his BP is on the high side now. shirleyann > My husband dreads another HT so I told him to refuse it for awhile. > > He just started Flomax -seed implant to be done on 3/20. I don't know much about brachy, but I understand that the more effect the HT has on the cancer inside the prostate, the more effective the seeds will be. I also don't know how bad his side effects are with HT. But, I would recommend he continue them for another five days. We are possibly talking life vs one more week of side effects. > My husband dreads another HT so I told him to refuse it for awhile. > [quoted text clipped - 6 lines] > > He is very stressed and his BP is on the high side now. Is he being treated for his HT (really, ADT) SEs? Although some of the drugs used to combat ADT SEs have their own significant SEs, they are in many cases less debilitating than the SEs they mitigate. And in the short term, as an adjunct to seeds, maybe one set of SEs is more tolerable than the other. Or maybe he'll have little trouble with the drugs combating his ADT SEs. Of course, there's the other obvious question, which I can't answer because I haven't paid a lot of attention to discussions here on this topic: does adjuvant ADT boost the effectiveness of seeds? Or is this just another case of doctors firing shotguns at the problem with little regard to SEs? I.P. > He still feels tired but goes to the gym 3 times a week. Assuming he's working pretty hard there, he's dong him *and you* a great deal of good in many ways. You *are* there, too, aren't you? I.P. I use my treadmill while he is gone 3 times a week. My husband has 2 knee implants and has osteoarthritis. He usually comes back in a good mood on the days he goes to the gym. Other days he is grumpy and argumentive at times. shirleyann > I use my treadmill while he is gone 3 times a week. That's a great start, but strength, flexibility, quickness, and balance -- not to mention companionship -- are all increasingly important as we age. Treadmills are just part of the formula, and a slim figure is only part of a healthy body. > My husband has 2 knee implants and has osteoarthritis. He usually comes > back in a good mood on the days he goes to the gym. Endorphines. Even people who do not enjoy working out (notice it's not called "playing out") get a big mental boost from busting their humps physically, even if it's due just due to increased circulation. > Other days he is grumpy and argumentive at times. When he grumps, shove him onto your treadmill and hold a burrito in front of his nose. A 20-minute jog will improve his mood, cardiovascular system, and waistline, and can be done every day, unlike strength-building exercise. I.P. My Zoladex shots were in the stomach. They never hurt during or after. Along with a daily dose of Casodex, I stopped treatment after 9 months because of weight gain, incresed Glucose levels and "trigger finger" a form of arthritis . I was part of a clinical trial testing these drugs as compared to the drugs plus chemotherapy. My Oncologist was suprised that I had left the study. Two weeks later he called me with the news that the chemo arm of the study had been halted because of too many patients developing lukemia. WSF > ... I stopped treatment after 9 > months because of ... "trigger finger" a form of arthritis. ... I also got this Sox. Now, three years after stopping HT, I still have it in one finger, though I had pain, stiffness and trigger finger in most of my fingers for a while. I find that hand exercises completely control the problem. Squeeze something strongly, many times a day. It can be a rubber ball, a hand exercizer, a steering wheel while you're driving, or your other hand. In my case, the pain and stiffness would completely (though only temporarily) go away. I also found that sleeping with a clenched fist prevented the problem at night. Alan > > ... I stopped treatment after 9 > > months because of ... "trigger finger" a form of arthritis. ... [quoted text clipped - 14 lines] > > Alan Hey Alan, Aside from hand exersizers (I have three of them at home, the office and the car) did you see a Rheumatologist? Did you take any drugs for the pain or swelling? If yes, which ones worked? WSF > Hey Alan, > [quoted text clipped - 3 lines] > > WSF I saw my family doctor. He prescribed anti-inflammatories. We started with ibuprofen and then tried naproxen. Neither one was even slightly helpful. He felt my finger joints, but couldn't find any obvious joint damage, i.e., bone spurs on the joints. He also did some blood tests, I think including one for the blood factor that indicates rheumatoid arthritis, but didn't find anything. He never sent me to a specialist. Heat and cold helped. If I ran my hands under the faucet with either hot or cold water, it relieved some of the stiffness. Then I went to the library and got some books on arthritis and read them. The symptoms I had matched rheumatoid arthritis - symmetrical pain in the small joints (fingers and toes). But the books said that in the early stages there are often no symptoms that show up on blood tests and no current way to get a definitive diagnosis until it gets worse. One of the books recommended exercise. It claimed that exercise could not only relieve symptoms, but could also slow or prevent joint damage. It recommended both flexibility and strength exercises. So that's what I've done and it has worked wonders for me. At one point I was doing over a thousand hand squeezes per day with each hand with one of those hand exercisers. The problem is no longer bad for me, but I still do several hundred a day with each hand - to keep it fully under control. I keep a couple of hand squeezers in the bathroom and use them when I wake up at night to go to the toilet. And I keep a rubber ball by the bed that I can use to quietly work out any kinks in the fingers without waking my wife. The only side effect I've noticed from my treatment is that I've gotten stronger hands. I like that much better than the side effects of the drugs. Alan > Aside from hand exersizers (I have three of them at home, > the office and the car) did you see a Rheumatologist? I urged him (in e-mail) to DEMAND a referral to a rheumy. > Did you take any drugs for the pain or swelling? If yes, > which ones worked? I was on Indocine from 1977 to 1999. Then Tylenol #3 until last year when I began ULTRAN ER200. They all kept the pain level down to a 1 or 2. Also on SOMA and FOSAMAX for the AS/RA itself. On Mar 6, 10:10 am, "laleves...@gmail.com" <laleves...@gmail.com> wrote: > My father is currently undergoing radiation and hormone therapy. Has > anybody on here had any problems with the hormone therapy? It's > really putting my father in a lot of pain. Almost to the point he > wants to stop. He had his 5th injection yesterday and I was shocked > to see the hole in his stomach from it! It gives him terrible burning > in the stomach and just physically wears him out. ... After over 8 years on hormone therapy, I have seen and felt a lot of problems. In your father's situation, there may be 2 different problems from your limited description. First, if he is having pain in the stomach injection area from the Zoladex, then the it is just plain incompetence. Here are the incompetent injections that I have experienced - even anesthetics didn't help. One was slow weak jabbing to get penetration which after many painful attempts it went in - left a painful wound that lasted for weeks. The second was a dangerous injection by jabbing the needle straight into the stomach - luckily I had enough fat for it not to penetrate the stomach. Now I grill the nurse before the procedure to make sure she has the competence to do it right. The right way does not require an anesthetic, it is a big pinch of fat tissue and a swift hard fast jab parallel to the stomach and an imperceptible pause and a quick out. There is a temporary pain for a few minutes and the penetration hardly bleeds. There should not be any persistent stomach pain. The side effects from the Zoladex drug are many and can be quite serious and debilitating for some patients. In quick summary, the loss of testosterone causes loss of libido, muscle strength, energy, drive. Consequently it causes estrogen to decline which results in loss of bone, short term memory, ability to multi-task, and emotional instability as well as hot flashes. It also causes bad cholesterol to rise and causes long term cardiovascular problems. Radiation therapy has it own adverse side effects that can compound the hormone problems. If your father's doctors are not solving these side effect problems, then maybe he should be looking for more helpful doctors. > After over 8 years on hormone therapy, I have seen and felt a lot of > problems. Hi, Lud. Welcome to the group! Eight years on HT? That's really good news to some of us. Can you tell us about your cancer? 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, <0.05 Non Illegitimi Carborundum > Hi, Lud. Welcome to the group! > > Eight years on HT? That's really good news to some of us. Can you tell us about your cancer? ~~~~~~~~~~ Hi Steve Here is the history in brief. It has not been fun but I have no debilitating effects yet and I hope to keep in low chronic mode. Take care ... Lud Dx & Tx history: ~~~~~~~~~~~~ Dx 1999 at age 59: bPSA 34, fPSA 8%, GS 3+4 (McNeal) Tx1 April 1999 - ADT2, Zoladex + Casodex At 6 months, PSA 0.22 - hormone resistance noted At 10 months, PSA down to 0.1 (no Proscar) BMD = osteopenia, start Fosamax continue for 4.5 years Side effects intolerable - stop Zoladex & Casodex Tx 2 March 2001, PSA = 0.04, IADT with Proscar Tx 3 March 2002, PSA 13.6, AADT High Dose Casodex 150 mg & Proscar Nadir Oct 2002, PSA 2.1 Tx 4 March 2003, PSA 4.6, add Zoladex to HDC &Proscar Tx 5 Sept 2003, PSA 1.05, Complete IMRT 80 Gy Tx 6 Sept 2003 continue with Zoladex alone (stop HDC & Proscar) Nadir June 2004, PSA 0.06 April 2004 discontinue Fosamax, add 3 quarterly Zometa (April, July & October 2004) and have 2 bone infections treated with ABX successfully, stop all bisphosphonates forever. Tx 7 Sept 2004, PSA 0.12, with Zoladex add Casodex 50mg Tx 8 Nov 2004, PSA 0.10, add Avodart to Zoladex & Casodex Tx 9 Jan 2005, PSA 0.14, change to TDE with Casodex & Avodart Tx 10 Nov & Dec 2005, PSA 2.32, replaced Casodex with Androcur - caused hemolysis - discontinue Tx 11 Feb 2006, PSA 3.8, discontinue TDE & Casodex, maintain Avodart Tx 12 May 2006, PSA 8.6, Taxotere (75 mg/M2) every 3 weeks Tx 12 June 2006 - after 3 TAX cycles - off treatment - maintenance with Avodart, Celebrex Aug 2006 PSA 2.95 nadir Mar 2007 PSA 14.2 - doubling time is 3 months -aiming for Provenge clinical trial in next few weeks, if not then I'll try LDK. >> Hi, Lud. Welcome to the group! >> [quoted text clipped - 10 lines] > Dx & Tx history: > ~~~~~~~~~~~~ Wow! You're really fighting the bastard! |
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