Guest guest Posted November 22, 2010 Report Share Posted November 22, 2010 Just found out today that my PSA has risen from a steady 53 to 85 over the last 2 to 3 months. I think we might move to Ketoconazole plus hydrocortisone as the next step, replacing the DES + Clopidogrel Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 Good luck to you. My doc switched me from Casodex to Ketoconazole plus hydrocortisone for a while, but it didn't do much, and I was one of those people getting uncomfortable side effects from the antifungal Ketoconazole. We then switched to Prednisone, which was a relief (10/06/09), but didn't have much of an effect on the PSA either. When we switched my every 3-month shot from Lupron to Trelstar (12/09/09)that finally had an effect, eventually getting down to 7.12, when we gave my body a break from the Prednisone or any other daily antiandrogyn. The PSA seems to be bumping up again, though. I go in again in December. I am unfamiliar with DES with Clopidogrel. I'll need to look that one up. We have discussed Provenge. 01/15/09 8.93 03/02/09 15.11 06/30/09 38.79 08/11/09 56.18 10/06/09 41.12 12/09/09 67.99 03/09/10 47.63 06/16/10 7.12 ‎ 09/15/10 19.20 > > > Just found out today that my PSA has risen from a steady 53 to > > 85 over the last 2 to 3 months. > > > > I think we might move to Ketoconazole plus hydrocortisone as > > the next step, replacing the DES + Clopidogrel > > > > > > Best of luck . We'll all be thinking of you. > > Alan > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 Hi . You wrote: > Just found out today that my PSA has risen from a steady 53 to > 85 over the last 2 to 3 months. I think we might move to > Ketoconazole plus hydrocortisone as the next step, replacing > the DES + Clopidogrel If you have any possibility of liver problems, I recommend that you exercise caution with Ketoconazole. See: http://www.rxlist.com/nizoral-drug.htm Where this warning appears: > When used orally, ketoconazole has been associated with > hepatic toxicity, including some fatalities. Patients > receiving this drug should be informed by the physician of the > risk and should be closely monitored. See WARNINGS and > PRECAUTIONS sections. > > Coadministration of terfenadine with ketoconazole tablets is > contraindicated. Rare cases of serious cardiovascular adverse > events, including death, ventricular tachycardia and torsades > de pointes have been observed in patients taking ketoconazole > tablets concomitantly with terfenadine, due to increased > terfenadine concentrations induced by ketoconazole tablets. > See CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS sections. > > Pharmacokinetic data indicate that oral ketoconazole inhibits > the metabolism of astemizole, resulting in elevated plasma > levels of astemizole and its active metabolite > desmethylastemizole which may prolong QT intervals. > Coadministration of astemizole with ketoconazole tablets is > therefore contraindicated. See CONTRAINDICATIONS, WARNINGS, > and PRECAUTIONS sections. > > Coadministration of cisapride with ketoconazole is > contraindicated. Serious cardiovascular adverse events > including ventricular tachycardia, ventricular fibrillation > and torsades de pointes have occurred in patients taking > ketoconazole concomitantly with cisapride. See > CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS sections. Scary, innit? Sorry to see the new issue arise, but I'm sure that you will cope. Best, Steve Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 Thanks to both Al and Steve for the heads up. So far I am not aware of liver problems, so it might be try it and see. I researched the side effects of Ketoconazole last night and the liver was highly underlined as well as odema of the ankles. Al in the UK we have come to terms with low dose DiEthylStilbesterol with an anti clotting agent, I don't think the USA has sanctioned its use. I'll research the Trelstar as an alternative to Zoledex Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 Al Haug wrote: > ... When we switched my every 3-month shot from Lupron to > Trelstar (12/09/09)that finally had an effect, eventually > getting down to 7.12 ... Al, That's fascinating. In theory, as best I understand it, all of the LHRH agonists (Lupron, Trelstar, Zoladex, Eligard) have no direct effect on prostate cancer. Their only effect is to greatly reduce testosterone levels, and _that_ has an effect on prostate cancer. If that's right, then whether a patient uses Lupron or Trelstar should not matter at all, unless one of them lowers the testosterone level more than the other. Did your doctor take testosterone readings on Lupron and Trelstar? Were they lower on Trelstar? If the Trelstar is working, then it would appear that your cancer is not yet hormone refractory, or not completely so. It may be that the Trelstar got your testosterone level down further than the Lupron did, and if you could get it down further still, your PSA would continue to go lower. I'm not sure how to get it lower still, but the fact that you may still be hormone sensitive is good news. Maybe it's worth adding dutasteride (Avodart), which supposedly has only mild side effects but reduces the bioavailability of the testosterone inside the cell. You may also benefit from one of the new investigational drugs - abiraterone or MDV3100. As I understand them, they are both used in hormonal manipulation and have shown good effect after LHRH agonists stop working. Best of luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 Funnily enough I met the rep for Decapeptyl (Triptorelin (acetate or pamoate) a few weeks ago, so it is definitely available in the UK. Though as Alan says there seems to be a view that one GNRH antagonist is the same as the next in terms of effect Re: PSA rise > Thanks to both Al and Steve for the heads up. > > So far I am not aware of liver problems, so it might be try it and see. I > researched the side effects of Ketoconazole last night and the liver was > highly underlined as well as odema of the ankles. > > Al in the UK we have come to terms with low dose DiEthylStilbesterol with > an > anti clotting agent, I don't think the USA has sanctioned its use. > > I'll research the Trelstar as an alternative to Zoledex > > > > > > > ------------------------------------ > > There are just two rules for this group > 1 No Spam > 2 Be kind to others > > Please recognise that Prostate Cancerhas different guises and needs > different levels of treatment and in some cases no treatment at all. Some > men even with all options offered chose radical options that you would not > choose. We only ask that people be informed before choice is made, we > cannot and should not tell other members what to do, other than look at > other options. > > Try to delete old material that is no longer applying when clicking reply > Try to change the title if the content requires it Quote Link to comment Share on other sites More sharing options...
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