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The dangers of Lupron

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Posted 6/20/2019 11:39 AM (GMT -5)
My last 3 month shot in November, anxiously awaiting Testosterone to rise from the ashes like a PHOENIX.
It went from 7 in early April to 48 3 weeks ago, to 67 today. At least I’m above castration levels now.

But there are other considerations here that scare me.
My Triglycerides, as ive mentioned many times here has always been a little bit of a struggle for me but I’ve had it under control before the Lupron started. My last three readings over the last six months were 250, 501, and today’s result which was 385. After the 250 measurement I was extremely diligent about eating low-carb’s, nevertheless, triglycerides doubled in a short time. I can only think it’s the Lupron . For anyone with heart disease and many prostate cancer patients are in that boat, he included, just based on age.
My cholesterol was never a problem it’s always been about the triglycerides and I’m actually pretty scared about this

I have to get it down. Doctor put me on that three weeks ago so maybe the meds are doing their job. But I also tightened up even further on the low carb and low calorie, trying to lose weight which is not easy with low testosterone .

Just something for everyone to be aware of when they are making these decisions . It’s a known fact that Lupron and other ADT meds have a side effect of promoting that about just what this is
Posted 6/20/2019 11:58 AM (GMT -5)
Prato,
I had to chuckle a little bit, because the title of your thread made me instantly think of dangers for me if I weren’t on Lupron. It actually made me laugh - which is always good.

Not trying to minimize your experiences on Lupron because it’s a serious chemical leading to serious issues. Testosterone is also a serious chemical, and not having any is bound to cause problems.
Posted 6/20/2019 12:01 PM (GMT -5)
If one thing doesn't get you then the next one will..Do everything you can do but don't destroy your quality of life doing it..
Posted 6/20/2019 1:07 PM (GMT -5)
I think it will resolve as your T levels rise.

but remember: sugar is evil.

Andrew
Posted 6/20/2019 1:34 PM (GMT -5)
one other thought comes to mind: Niacin (Vitamin B3)

have you talked to your doc about that? Once my my Triglycerides/LDL was getting out of hand, my doctor had me take that for awhile. It worked to lower the levels, but did cause flushing that was most annoying (doesn't happen to everyone). Maybe a short term round of that might help till the T-levels are back.

Andrew
Posted 6/20/2019 3:44 PM (GMT -5)
I belong to a Facebook group that promotes low carb - low fat. The question comes up time and time again about cholesterol and triglycerides - the person's reading almost always goes up before it starts to come down. If I remember correctly the science behind this is that as the person starts to burn fat for energy, the fat starts to break down and releases all those lovely triglycerides into the blood stream. It takes awhile to for everything to even out and show a downward trend.

So don't get discouraged yet. It could take 6 months to a year of eating low carb before you see results.
Posted 6/20/2019 3:59 PM (GMT -5)

mattam said...
Prato,
I had to chuckle a little bit, because the title of your thread made me instantly think of dangers for me if I weren’t on Lupron. It actually made me laugh - which is always good.

Not trying to minimize your experiences on Lupron because it’s a serious chemical leading to serious issues. Testosterone is also a serious chemical, and not having any is bound to cause problems.

Mattam, glad you laughed. The reality is, to steal word or two from another thread, it can be a quagmire (or dilemma) for those at high risk. Pass on the Lupron and deal with advancing PC, or take the Lupron and risk heart disease (or more heart disease).

Reason for my post was really just to remind guys, especially guys that might be new here, and are experiencing BCR, but are low risk, that this treatment doesn’t come without risk.
Posted 6/20/2019 4:03 PM (GMT -5)

InTheShop said...
one other thought comes to mind: Niacin (Vitamin B3)

have you talked to your doc about that? Once my my Triglycerides/LDL was getting out of hand, my doctor had me take that for awhile. It worked to lower the levels, but did cause flushing that was most annoying (doesn't happen to everyone). Maybe a short term round of that might help till the T-levels are back.

Andrew


Thanks Andrew, I tried it when my TG went to 250. Obviously it didn’t help. I’ve been on Niaspan too, it didn’t do much either.
The med I’m on now is Vescepa. Concentrated omega 3.
In any case, it was my choice, but guys need to be aware.
Posted 6/20/2019 5:48 PM (GMT -5)

Union98 said...
If I remember correctly the science behind this is that as the person starts to burn fat for energy, the fat starts to break down and releases all those lovely triglycerides into the blood stream.

Ketosis...
https://www.medicalnewstoday.com/articles/180858.php
Posted 6/20/2019 6:06 PM (GMT -5)
My triglycerides behaved during ADT, but total and LDL cholesterol spiked. Given my family history of heart disease, my PCP recommended starting on atorvastatin rather than waiting to see if testosterone recovery brings the numbers down. Next blood test in 4 wks, we’ll see if it works.
Posted 6/20/2019 6:57 PM (GMT -5)
I'm a Type 2 diabetic w/ CAD. Long ago I had very high triglyceride numbers. I'm on Metformin - but noticed when the doc put me on a statin the triglyceride levels plummeted. One doc had me on niaspan - another doc took me off it and my triglyceride numbers didn't change a bit. Currently it's at about 50. So it's apparent I gained to advantage with niaspan whatsoever (when it came to triglycerides).

If I ever have to cross that SRT bridge (knock on wood I won't) I'll probably decline ADT since the added 5-10% probability of preventing a second recurrence would not be worth it considering both my Pca history and heart disease.

I do feel sorry for those guys who have heart disease and must go on long-term ADT. It places them between a rock and a hard place. Trying to medically manage all those biochemical factors that exacerbate heart disease while undergoing ADT treatment must be a real struggle.

There is always exercise for those who can actively participate. Diet also plays a crucial role.
Posted 6/20/2019 7:13 PM (GMT -5)
I find the discussion of Lupron causing or contributing to heart problems interesting. My last two MOs have told me there is not much, if any, evidence for this. Have I been misled?
Posted 6/20/2019 7:42 PM (GMT -5)

mattam said...
I find the discussion of Lupron causing or contributing to heart problems interesting. My last two MOs have told me there is not much, if any, evidence for this. Have I been misled?


Cardiovascular effects of hormone therapy for prostate cancer
Posted 6/20/2019 8:25 PM (GMT -5)
Saipan,
Thanks for posting the article. It appears to be quite interesting. I haven’t read it entirely yet, but apparently the conclusion is:

“It is clear that overall, the use of ADT in the treatment of prostate cancer is associated with an increased risk of cardiovascular complications. However, for the most part the excess risk is modest though significant, and must be weighed against the equally clear benefits of ADT in appropriate patients.”

Notice the part I italicized. What the heck does that mean? lol I’m thinking maybe they are saying there is some risk, but not enough to worry about? Perhaps the anxiety of worrying about the effects of Lupron on cardiovascular issues may be more damaging than the Lupron itself. Who knows?
Posted 6/20/2019 9:44 PM (GMT -5)
Mattam, I was thinking the same thing, WTH does that mean?

SP, thanks for posting that article, it’s worth saving
Posted 6/21/2019 12:13 AM (GMT -5)
Based on what I've read the PCa patients who are at the greatest risk for cardiovascular complications while undergoing ADT are those with preexisting heart disease. Those large studies seem to show patterns that make logical sense. I happen to fall into that category. As a 3+4 who made it past my 3rd RALP anniversary w/o a relapse - should I recur in the future and the RO offered me ADT I'd likely turn it down knowing what I know today. Now if I happened to be a 4+4 or 4+5 I would strongly consider other options. However, I consider my heart disease w/ T2D way more lethal (potentially) than my PCa - and don't want to aggravate it. Now, men who do not have preexisting heart disease may well want to roll the dice since the literature appears to claim that their risk for cardiovascular complications while on ADT is not at the same level as men who do. And some men with conditions same or similar to my own may want that 'apparent' 5-10% ADT advantage to beat PCa w/SRT. All is fair in love and war. Look, this stuff is all a big fat gamble. All one can do is self-educate, get a few opinions from the "experts", then take that data, go with a gut instinct and just throw the darn dice, and don't look back. So is life.
Posted 6/21/2019 1:06 AM (GMT -5)
"modest but significant": I think it means that despite the authors' best efforts, their review of the literature leaves them in the same dark corner they were in to start with -- it sure looks like maybe ADT's bad for your CV system, but really there's no telling.

If you and your doctors are more worried about your heart condition than your cancer, maybe lay off the lupron.
Posted 6/21/2019 9:03 AM (GMT -5)
Sometimes you just have to roll the dice and get on with it. As a GS9, highly aggressive cancer, with CAD, and a double bypass, clearance by my cardiologist was necessary for my treatment plan. To be honest, I don’t remember much discussion if any regarding the interaction and consequences of the use of ADT and coronary artery disease. After finishing 18 months of ADT a year ago, and a stress test a few months ago, I’ve had no issues. Thank God...
Posted 6/21/2019 11:20 AM (GMT -5)

TJ123 said...

....If I ever have to cross that SRT bridge (knock on wood I won't) I'll probably decline ADT since the added 5-10% probability of preventing a second recurrence would not be worth it considering both my Pca history and heart disease.

Good decision TJ. The many long term impacts of ADT have never been fully evaluated. When I did extensive research almost two years ago, The added ADT benefit was no more than 3% in my case. Lots of Uros and most RO's, even the celebrity stars, seem to recommend it, not fully grasping (or caring??) about the short and long term QoL impacts on us.

Even being forewarned many, including me, still opt for taking the ADT. I don't think I'd do it again. Caveat Emptor, brothers.
Posted 6/21/2019 3:29 PM (GMT -5)
I too would think more deliberately, if I had it to do over. Not sure, I might have done it anyway, had I fully grasped the potential effects, but i would have done more than follow my surgeon and RO’S reco’s.

For me, water under the bridge, for other guys behind me. Think it through very deliberately, as though your life depended upon it,
Posted 6/22/2019 9:09 AM (GMT -5)
I'm doing some aggressive treatment plans. The oncologists and Cardiologist all explain that I should consider death from PCa, coronary, or stroke to all be the potential outcome with all the meds I'm on.

My last instructions explain that my obit should say PCa if any of the above happen.

I think I've been warned!
Posted 6/22/2019 9:54 AM (GMT -5)
After a PET scan identified tiny tumers in 2 small regional lymph nodes, a well respected URO/ surgeon recommended 24 months lupron along with RT. RO recommended 18 months lupron. I decided on 6 months which for my situation was enough.
After SE and what I have read by posters on this forum, I believe I made the right decision.
We all have a choice.
Dave
Posted 6/22/2019 5:22 PM (GMT -5)
My cardiologist is in the middle now researching an odd occurrence with my heart. My heart for years has been moderately enlarged. I had a lung X-ray last week to check for lung issues from one medication. The report came back normal and surprisingly no heart disease or enlargement seen. Doc had it repeated to make sure no reading error. Doc says Lupron doesn’t shrink heart muscle like skeletal muscle but I have read it does. He is at a loss to explain, interested to see what happens as Lupron wears off going forward.
Posted 6/23/2019 2:25 PM (GMT -5)
Well, my experience was a little different (sounding like Kate McKinnon describing her abduction by aliens)... I was put on Lupron by my RO at four months after RP, and I knew very little about it. Based upon my calculated PSA-DT and velocity, if I had not had the RP, my PSA would have been 40 by the time I started HT. And if I'd not had the HT it would have been 60 by the time of my adjuvant RT. Fortunately all three treatments had commenced within a year.

Due to external events surrounding my diagnosis, I didn't have much opportunity to shop around or pick and choose treatments. (See my brief one page mini blog) Fortunately, other than a persistently borderline high triglyceride level, my cardiovascular system is generally healthy... though the Lupron has caused elevated A1C, heart rate and BP. My GP doesn't know much about HT, my RO is retired and my current Uro is not a great source of information. But I'm hoping that at some point my testosterone production will resume and PSA will remain undetectable.

Other than osteopenia and depression, hopefully the SE's of my 18 months on Lupron (30 months so far) will be minimal. Hopefully. Would I do it again? I didn't have much choice.
Posted 7/11/2019 8:44 PM (GMT -5)
what does radiation colitis feel like and the effects of it are?

I have been having some pain and burning in my stomach and some intestines for the past three months. I cant tell if its gastritis, cancer growth or radiation side effects. I did IMRT + high dose brachy treatment 4 years ago.
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