| Subject: | Hormone Therapy/PCa |
Regarding the question of Casodex, the patient may discontinue it; I do not think adding it to radiation + lupron for 2 years is better than not adding it. It has not been tested in this setting, to my knowledge. I agree that he needs to continue Lupron for at least 2 years, and if PSA starts rising in the future after he has been off Lupron, the common thing we do is to resume Lupron again, until it stops working, at which time, Casodex may be used with some patients responding for some time. I would however stop Megace because it may cause progression of his prostate cancer. There have been reports of rise in serum PSA in patients taking Megace. Also, there is concern about Megace causing blood clots, high blood pressure, weight gain etc. To help reduce the hot flashes, I would propose trying drugs commonly used for depression but helpful for hot flashes, Lexapro, Effexor, Paxil, or Remeron.
-Nizar Tannir, M.D.
| Posted: 22 Jun 2004 01:33 PM |
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