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Information about Firmagon (Degarelix) please


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Snowy asks:

Degarelix   (Firmagon) has just been put on the NHS in UK  for men with advanced hormone dependent prostate cancer whose disease  has spread to the spine.   Does anyone in Australia have any experience and knowledge of Degarelix please?

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My doctor has put me on Firmagon.


Jim Marshall (not a doctor) said ...

In short

Firmagon is a hormone treatment that robs the body of testosterone like other hormone treatments. It is most often used to start a man on hormone treatment, or for men with certain heart conditions.


More detail

Firmagon (Degarelix) has been available for some time in Australia. It is supplied on the PBS for locally advanced or metastatic prostate cancer.


It is a form of hormone therapy (also called androgen deprivation therapy (ADT)). Its special feature is that it removes testosterone from the body very quickly.


Firmagon is useful as a first treatment for men who walk into the doctor's with advanced disease - locally advanced or metastatic. 


Other hormone treatments - Zoladex, Lupron, Eligard etc - temporarily raise the testosterone for some days when they are first given. This is called the initial 'flare'. The growth boost the testosterone gives to the cancer can cause pain in cancer from bones, or cause locally advanced cancers to swell causing blockages.


Doctors try to lessen this flare of the other hormone treatments by giving a anti-androgen tablet for a couple of weeks before starting.


But with Firmagon there is no flare. So now doctors seeing men for the first time may use Firmagon initially for a month or two, then change to one of the other hormone treatments.


Men who have had certain heart conditions may be prescribed Firmagon as their primary hormone therapy because it seems that it may be safer for these men.


Studies in the lab in test tubes and animals suggest it may be useful to look at Firmagon to see if it might also be better for the bones, but there is no evidence for that in humans as yet.


There are two problems with Firmagon as long term treatment. 


Firstly, the injections need to be given every 28 days. Other types of hormone treatments only need to be given every 3, 4, or six months.


Secondly, the injection site (abdomen) becomes very painful an hour or two after the injection, and that pain lasts a day or two or three. This is such an inconvenience that men whose doctors prescribe long term Firmagon often change to another hormone therapy instead.

... end Jim

More information

Email only: Click on the Go to this Topic button below in this email to go to our Forums website.

Website: On our Forums, use the search box near the top right of each page.

Your hormone therapy drugs may be on our Drugs list:http://www.jimjimjimjim.com/drugs.html


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G'day Snowy,

Jim has covered most of the bases. I'd add that Firmagon's other claim to fame is its capacity to drop testosterone (and hopefully PSA if the cancer is not yet castrate resistant) more rapidly than Zoladex , Lucrin, Eligard etc:  this benefit is important if bone mets are causing pain or if there is a likelihood of vertebral compression affecting spinal nerves. 


I used Firmagon in place of Zoladex for a few months, when intermittent ADT began to run out of steam. I found the injection site discomfort to be mild, rather than very painful - but this can depend on the injection technique used by the doctor. You should ask about this!



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As Jim says, use the search box.  You'll find lots of information that's already been posted about Firmagon.

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