Lupron Shot

GuyBMeredith

Mine were pretty normal needle work, though Julie thought the needles were larger than normal. I was given them in the buttocks, required to alternate although the three shots were over a month apart. They made sure the needle went into the muscle.

Common effects of first lupron injection is a testosterone flare which some men say ups sex drive for a few weeks. I never noticed this effect. The bicalutamide may repress it. Jim may have more information on that.

After the first few weeks, the menopausal symptoms kick in. Again, bicalutamide may have your husband there already. So for me it settled down to a grind of menopausal symptoms and an academic regimen of sexual activity.

__________________
Diagnosed at age 73 Feb 2019 DRE indicates nodule PSA 2.8 Aug 2019 PSA 3.1 Urologist suggests biopsy in Oct Results of biopsy: 2 of 12 cores positive. Low volume T2b, intermediate risk, GS 3+4, PSA 3.10, prostate cancer, perineural invasion. Followed up with MRI to help decide between surgery and IMRT. MRI shows suspicious PIRADS 5 lesion measuring 2.cm in diameter, with associated left neurovascular bundle involvement. Started 6 month lupron series Feb 2020, 28 sessions of high dose IMRT Apr 15, 2020. Sexual functions okay except ejaculate has changed. Without libido it is an academic process that requires much focus. July 27 first measure of PSA and total testosterone. PSA: .13 ng/dl Total testosterone is less than 12 ng/dl.

guitarhillbilly

Have had 3 Lupron Injections in 13 months and here's my experience.
[Last One was DEC 2020]
Shot was given in the left upper buttock while all my body weight was shifted to my right leg and side. Experienced Mild discomfort during the injection.
Injection site and buttock was moderately sore for about 2 days afterwards.
No Pain.

__________________
T2a / Gleason Score 8 / PSA at Diagnosis 6.9 /
1-5 aggressive score : 4
12 cores= 4 positive
NBS = Negative
Pelvic CT= Negative
Pelvic MRI= Negative
Age at Diagnosis= 60-65 age group
Completed 42 IMRT Sessions
Lupron scheduled for 2 years [Started DEC 2019]

JWPMP

Thank you Guy & GH
Appreciate that you share your personal experiences.
Reading it is one thing, hearing the reality is another.
Paula

IADT3since2000

Hi again.

I experienced minor discomfort during the injection.

My shots were given by a urologist for the first nine months. I routinely experienced soreness in the butt for several nights if lying on that side - enough to keep me from doing that.

Later shots were given by technicians at my medical oncologist's practice, and the shots were routinely given higher up in the butt muscle. I still experienced some soreness, but it was substantially reduced. I believe the position of the shot, which needs to be into muscle and not fat, affects the amount of discomfort.

I just posted a new thread about Orgovyx® (technical name relugolix), the just approved oral drug that is more or less an equivalent of Lupron. It looks like an alternative that deserves consideration. If you want to go ahead with Lupron right now, that would probably allow substituting Orgovyx when the Lurpon runs out. You might want to call the doctor right away about this.

….Jim

- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

JWPMP

I will definitely ask the doctor about the Orgovyx.

Thanks for the experience with the shot. Didnt know if it was a long process and if there were any immediate reactions.
Since the doctor wanted his first injection at UCSF I was anticipating another long day. Maybe not.

Were the side effects the same or more intense on Lupron than the Bicalutamide?

Thank you again
Paula

DaveinMaryland

I experienced only minor side effect from a 6 month Lupron shot. As I recall there was soreness after the injection high in the butt. It took about 2 weeks before my libido diminished rapidly to the point that they could have required all women to not wear clothes and all I would have cared about is if they were going to be cold.

After that any effects were minor. I didn't experience hot flashes just very occasional warm flashes. My wife told me those were not hot flashes. I didn't gain the anticipated 10 lbs. I had a bit of fatigue but that was expected since I was also undergoing radiation treatment. It was not debilitating. I felt pretty normal. I upped and maintained an exercise program. I really believe that had a lot to do with minimizing effects.

__________________
Dx at age 63 March 2017
Prostate Cancer 3+4 Open RP May 2017
PSA detectable May 2018, single digit .1 2 digit .06
August 2018 2 digit .07
November 2018 2 digit .10
6 month Lupron Shot Dec 2018
Salvage Radiation Jan - Mar 2019
Nov 2019, June 2020 Nov 2020 PSA undetectable

JWPMP

Wow Dave great to know.
Thank you.
Jim has had few side effects with the bicalutamide so far except hot flashes (I would also classify "warm flashes" since I myself had/have true hot flashes Lol)
His biggest complaint is dizziness.
He's been feeling sea sick for about a week. But he's staying very active so hopefully, like you, his side effects will continue to be mild.
Thanks again
Paula

IADT3since2000

I started bicalutamide after Lupron the first time and just a few days earlier for the second and third cycles, switching to flutamide for the fourth, so I don't really have personal experience of side effects of bicalutamide by itself. My impression is that bicalutamide is pretty mild and that it is the Lupron that causes the side effects that need to be countered. Maybe someone else can pitch in here.

….Jim

- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

IADT3since2000

Hi Paula,

You wrote:

I hope he gets over that sea sick feeling. My impression is that nausea is not a common side effect of bicalutamide, so there may be a different cause, but so many drugs have odd and unusual side effects that affect a few patients, and he may be one of those patients. There are some older as well as some fairly new drug alternatives in the same antiandrogen class as bicalutamide, and I'm thinking there's a good chance another such drug would not cause nausea.

Regarding dizziness, I never had that exactly, but I recall a slight unsteadiness at times, and I think it was mostly toward the beginning of therapy. Famed medical oncologist Charles "Snufffy" Myers, with a large practice dedicated to prostate cancer but recently retired, advised men on ADT to keep their heads slightly forward if they were experiencing balance issues. I have done that at times and believe it helps.

….Jim

- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

JWPMP

Good information Jim, thank you.
I was thinking if the sea sick thing doesn't subside I'll message his doctor.
The dizziness seems when he's on a ladder or under the truck
( he's restoring a 1946 Chevy)
or if he gets up too fast.
I'm wondering if he might be experiencing a bit of vertigo, not actually dizziness and nausea separately.
Anyway, hopefully it will subside.

I did message Dr Borno regarding the Orgovyx but have not received a response.

Thanks again
Paula

Prostatefree

Check his blood pressure.

IADT3since2000

The part about occurrence when he gets up too fast looks like "orthostatic hypotension," which is not uncommon. I've experienced that too at times, not at present. As suggested earlier, low blood pressure, magnified by the getting up movement and the patient's biology, could be the cause.

….Jim

- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

JWPMP

thank you, did not think of that at all
Paula

IADT3since2000

And thank you Paula for reminding me about that. Looking back, I realize that I probably had orthostatic hypotension for much of my ADT treatment, though it was a minor problem as I just would take a few seconds while rising from a seated position, which prevented "seeing stars." I now recognize that I have not had that issue at all for years. It's probably an ADT thing, though minor, and easily countered.

….Jim

- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.