Which is more effective - Lucrin or Zoladex?

[Kezza2]

A question for the experts - has anyone seen any information on the relative effectiveness of Lucrin verses Zolodex ??  I have been on intermittent Lucrin injections for 15 years, and its effectiveness seemed to be reducing recently, so we changed to Zolodex plus added Cosudex.   I really dislike the Zolodex injections so we have changed back to Lucrin, but I do not want to compromise my treatment and will put up with the Zolodex if it is more effective.

 

Any comments ??

 

 

[Moderator - This post has been moved.  If you've got a new question, start a new discussion, rather than interrupting an existing discussion.]

[Charles (Chuck) Maack]

Which is more effective - Lucrin or Zoladex?

 

Generally, both are equally effective. The below study indicated that triptorelin was a bit more effective when administered in monthly doses than leuprolide, but not overly significant.  The same study indicated that goserelin for some men was not totally effective in bringing testosterone level to 20ng/dl at 6 months.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725306/

 

Since we are on this androgen deprivation subject, thought I may as well provide a bit more information so you and other readers who may not know may have a better understanding of why androgen deprivation medications are prescribed and what they perform:

 

Explanation of what occurs to testosterone production when administered either one of the LHRH (also known as GnRH) agonists (Lupron, Zoladex, Eligard, Trelstar, Vantas) or the GnRH antagonist Firmagon/degarelix (their effectiveness in reducing testosterone levels to clinically castrate level (now considered below 32ng/dl – but preferred below 20ng/dl) is generally equal:

 

GnRH:   Gonadotropin-releasing hormone

LHRH:   Luteinizing hormone–releasing hormone

FSH:      Follicle-stimulating hormone

LH:        Luteinizing hormone

 

LHRH (aka GnRH) Agonists:

 

Lupron: Leuprolide Acetate

Zoladex: Goserelin Acetate

Eligard: Leuprolide Acetate

Trelstar: Triptorelin Pamoate

Vantas:  Histrelin Acetate

 

GnRH Antagonist:

Firmagon: Degarelix

 

 

(Some of below info from http://www.harvardprostateknowledge.org/hormone-therapy-for-prostate-cancer)

 

LHRH agonists flood the pituitary gland with messages to crank out LH.  This causes a temporary surge of testosterone produced by Leydig Cells in the testicles until receptors in the pituitary are overloaded.  Then testosterone levels drop sharply.

 

With this surge of testosterone an effect known as “flare” can occur.  It is important that an anti-androgen be prescribed (more often bicalutamide, generic of Casodex at one 50mg tablet daily). The anti-androgen should begin to be taken orally at least 7 days prior to injection of the LHRH agonist.  This is done to prevent or diminish the effects of initiating the LHRH agonist which routinely results in release of LH, stimulation of gonadal testosterone and increased growth of PC with release of PSA. The cell populations that are stimulated involve both benign and malignant prostate cells.  In patients with bulky disease that is compromising spinal cord, ureters, or seriously involving bone, this paradoxical stimulation at the start of LHRH therapy can result in medical emergencies such as spinal cord compression, ureteral blockade or severe increase in bone pain.  Even in patients without bulky disease, increases in LH, testosterone and PSA have been detected despite using 7 days of an anti-androgen.  However, even though the PSA does increase, this effect is markedly dampened by the priming doses of antiandrogen which results in a fall in PSA within 24 hours. Therefore, the antiandrogen prevents testosterone released during the initial surge from the LHRH agonist from doing major damage from initiation to as long as ten days to two weeks later before the flare subsides. 

 

In a different manner, the GnRH antagonist jams receptors in the pituitary gland so that it cannot respond to the pulses of LHRH sent by the hypothalamus.  This prevents the LH signal from being sent – and no testosterone is made in the testicles.

 

Chuck

 

DISCLAIMER: Please recognize that I am not a Medical Doctor.  I have been an avid student researching and studying prostate cancer as a survivor and continuing patient since 1992.  I have dedicated my retirement years to continued research and study in order to serve as an advocate for prostate cancer awareness, and, from a activist patient’s viewpoint, to voluntarily help patients, caregivers, and others interested develop an understanding of prostate cancer, its treatment options, and the treatment of the side effects that often accompany treatment.  There is absolutely no charge for my mentoring – I provide this free service as one who has been there and hoping to make your journey one with better understanding and knowledge than was available to me when I was diagnosed so many years ago.  Readers of this paper must understand that the comments or recommendations I make are not intended to be the procedure to blindly follow; rather, they are to be reviewed as my opinion, then used for further personal research, study, and subsequent discussion with the medical professional/physician providing your prostate cancer care.

 

Always as close as the other end of your computer to help address any prostate cancer concerns.

 

"What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others."

 

   “Sepius Exertus, Semper Paratus, Semper Fortis, Semper Fidelis, Fraters Infinitas”

“Often tested, Always Prepared, Always Courageous, Always Faithful, Brothers Forever"

 

 

Charles (Chuck) Maack - Prostate Cancer Patient/Activist/Mentor

(A mentor should be someone who offers courtesy, professionalism, respect, wisdom, knowledge, and support to help you achieve your goals; would that I succeed)

Recipient 2008 Us TOO Intl., Inc., Prostate Education & Support Network “Edward C. Kaps Hope Award”

Recipient 2012 Prostate Cancer Research Institute (PCRI) “Harry Pinchot Award” 

Email: maack1@cox.net

My website "Observations"

http://www.theprostateadvocate.com/observations.html

[alanbarlee]

Hi Kezza,

If you google 'leuprolide vs goserelin' you'll find a number of useful medical articles that cover efficacy and side effects.

Good luck,

Alan B