PS - My last post did not give details regarding side effects, and I realize that that is what you probably wanted.

While the Primer has much better detail, here are some of the main ones, with statistics from the medical co-author's practice as stated in the Primer:

- hot flashes (about 48% get them to some degree, with 25% getting them to a really annoying degree). They can be counteracted with medication very effectively for most men, but more of us will have milder flashes that don't require medication A book by Dr. Mark Moyad considers the incidence to be 50 to 66%, not far from the 48% used in the Primer. (The Primer's author is an expert; Dr. Moyad is generally knowledgeable about prostate cancer but is not expert in blockade; I assume he is basing his numbers on a research study.) A book with particularly strong coverage on countering flashes is "100 Questions and Answers About Prostate Cancer," Ellsworth, Heaney, and Gill; the 2003 edition describes them around pages 133-135. It goes into the specifics of several different medications and the possible role of soy.

- decrease or loss of libido (quite common, with about 90% having at least some decrease). Sets in gradually over several months. Partial to substantial ED also for most of us. Both are reversible when blockade is stopped, but radiation may affect ED.

- bone and joint pain (30% of us, with 4% having it to a really bothersome degree)

- decrease of bone density (quite common, though probably quite mild with short term blockade. Can be very effectively counteracted with a bisphosphonate drug (like Fosamax, Boniva, Actonel, etc.) plus calcium and vitamin D3 supplementation (wise to have a Bone Mineral Density scan - Primer discusses DEXA scan vs. qCT scan).

- Anemia (45% with 13% having substantial anemia that might require medication such as Procrit) This means that about 87% of us will not have a significant problem with anemia. It's important with all these side effects to think of the glass as half full, not half empty.

- Weakness (56%, with 5% experiencing substantial weakness). Aerobic and weight bearing exercise are particularly important and effective here, though they generally help counteract many of these potential side effects.

- Hypercholesterolemia (57%, with 34% having it to a substantial degree). Statin drugs help with this side effect as well as with overall survival of prostate cancer. Nutrition, diet, supplements and exercise will also help.

- Gynecomastia (breast growth and tenderness - 38%, with 19% experiencing it to a bothersome degree) Possible but not common from just the shot alone or in combination with an antiandrogen drug. Very common with an antiandrogen (like Casodex or flutamide) used alone.

- Mental/Emotional changes (17% with 14% reporting these changes to a quite bothersome degree)

The Primer has a table covering most of these on page 153. It covers impotency on page 151 and bone density issues on pages 142-143.

I've just mentioned some of the main countermeasures. There are others, and it's helpful for us to use them.

As a general rule, younger men, say in their 50s or younger, have stronger side effects on blockade than do older men.

I've been on intermittent hormonal blockade as my sole therapy for a challenging case for over 8 1/2 years. Like most men who are treated with hormonal blockade, I have found the side effects to be a nuisance and somewhat bothersome but basically quite tolerable. Some of us have a very hard time. One approach is to start blockade with a one month shot and see how you do. At the end of that time, you should have a pretty good idea. If the side effects are too strong (usually hot flashes and sweats) and uncontrollable, then you can knock off the blockade or switch to just an antiandrogen or antiandrogen with finasteride or Avodart. The main issue there is gynecomastia, and there is an optional approach to counteracting that - a short course of radiation to the breasts. Liver function is affected in a few of us, and this can be serious if not addressed, so Liver Function Tests are routinely performed until it's clear how the patient handles the antiandrogen drug.

Again, I'm not a doctor or medically trained, so please just take these as suggestive leads and not as authoritative information.

Jim

[QUOTE=mike999;3619521]This is a message to Jim:

I read your response regarding hormone shots...do you I read you correctly that you have been taking shots as your only treatment for cancer ?

Thanks,

Mike

Hi Mike,

My only treatment has been intermittent hormonal blockade, for which shots have been the foundation, as daff mentioned, plus pills that deliver an "anti-androgen" drug (Casodex, 50 mg for me) and a "5-alpha reductase inhibitor" drug (finasteride, which used to be called Proscar, for me). That's known as intermittent triple blockade with Proscar maintenance, or triple androgen deprivation therapy with maintenance, or similar names. Most of us on that therapy are also taking a bisphosphonate drug to preserve bone density and, if the drug is Zometa, to help avoid, control or reverse bone metastases. As daff noted, nutrition, diet, supplement, and lifestyle tactics including exercise and stress reduction are also part of my therapy. I'm also taking a statin drug primarily because those drugs appear to help us avoid lethal prostate cancer; of course, it also helps control cholesterol.

I wrote about my eighth year anniversary as a survivor and gave my story in two threads last winter. Those threads included details, if you are interested.

I chose this therapy in 2000 because it then looked likely that no local or combination therapy would be curative and I would have the side effect burden without the curative benefit (still looks that way). It now appears that knocking down the volume of cancer, even without getting it all, may provide a substantial benefit, but patients like me are faced with the question whether to stick with our current course or add a non-curative approach, with its additional side effects, that may or may not provide a substantial benefit.

Some low risk patients are choosing this therapy, and it appears that many only need one round of full blockade of about a year before knocking off the heavy duty drugs and continuing with just finasteride or Avodart for maintenance.

Intermittent triple blockade with maintenance is probably rarely curative, but it appears to offer long-term control for many patients, perhaps indefinite control. It's a judgment call, and hopefully more papers describing results will be published in formal medical literature about this approach. At the moment, there has been only one paper in a major journal, plus a few other publications. There have been a number of presentations at medical conferences and informal publications.

Take care,

Jim