Recently diagnosed, I'm learning as much as possible before my first meeting with my new medical oncologist. I know that Lupron is usually a part of a triple hormone blockade regimen but have searched posts and can't find how it is administered.
Is it injected or IV? How frequently is it administered? For how many months? Is it usually administered throughout an entire 13 month intermittent androgen deprivation program or just to kick it off?
This may seem obvious to many but I've been unable get specifics from my online searches.
I'm not the expert, but what I've learned is that there is a 30mg version that lasts 4 months, a 22.5mg version that last 3 months, and a 7.5mg version that lasts 1 month.
Why would a doctor choose one over the other? I dunno, but some of the guys who have been down that road can hopefully add insight.
I am a veteran of about 10 1/2 years of intermittent hormonal blockade, the vast majority of the "on-therapy" periods being triple blockade. Both kcon and WhiteLightening have stated the key facts. I'll insert some more comments in your initial post in green.
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Originally Posted by jamesrobt
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Is it injected or IV? How frequently is it administered?
There is a medically equivalent - equally effective - drug (Zoladex) in the same class that is injected in the stomach muscles. These drugs are expensive, and this drug will go generic this year, though it may not be available that soon. At least one other drug in the same class, Viadur, is an implant that can last a year.
For how many months?
My impression is that the experts in hormonal therapy like to start with one month injections to see how the patient does. For instance, they will get testosterone and DHT tests at the end of the month, a few days before the shot is due in the 28 day cycle, to make sure adequate blockade has been achieved. Some patients, for instance, clear the drug substantially faster than the norm, and the dosing time frame can be adjusted for such patients. Some doctors are casual whether to use calendar month dates or 28 day months. The experts all recommend counting a month as 28 days, with three and four month cycles calculated accordingly.
Is it usually administered throughout an entire 13 month intermittent androgen deprivation program or just to kick it off?
It needs to be administered to maintain adequate blockade throughout the period. That sometimes amounts to one or more one month shots at the beginning and at the end, with multi-month shots in between, for whatever period is used as the first "on-therapy" cycle.
This may seem obvious to many but I've been unable get specifics from my online searches.
Thanks.
Dr. Robert Leibowitz, Compassionate Oncology I believe, is the foremost proponent of the 13 month cycle for the first on-cycle. Dr. Strum has written about his own practice (with Dr. Scholz, and later Lam after Dr. Strum's semi-retirement) in "A Primer on Prostate Cancer - The Empowered Patient's Guide." They used a different criterion for eligibility for going off therapy: achieving a PSA <0.05 and maintaining it for a year. More recently, my impression is that they are less stringent about the year part, but I believe they want it to be <0.05 for at least nine months, or to have at least nine months on triple blockade, which would usually be a bit shorter. Dr. Charles Myers has also written extensively about hormonal blockade, including triple blockade.
