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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I was recently diagnosed with metastatic prostate cancer, which

Resolved Question:

I was recently diagnosed with metastatic prostate cancer, which has spread to my bones. My Consultant has put me on Zoladex and Casodex. He thinks testes removal is not necessary, but I think it can't do any harm and is more natural than drugs. What are your thoughts please?
Submitted: 3 years ago.
Category: Urology
Expert:  Dr. Tharun replied 3 years ago.
HI

How is your PSA?

What is the Gleason score ?

Do you have side effects of these drugs ?

Please let me know.

Dr.Tharun
Customer: replied 3 years ago.
PSA in early 2009 at diagnosis was 23 and the Gleason score was 7.8. After being given radiotherapy and Zolodex PSA was 0.1. However, since January 2014 has now risen to 60. Recent bone scan showed metastasis to hotspots in spine and hip and shoulders. Have been on Zoladex for 5 years and have only just been put on Casodex also for the next three months until next Consultant appointment. No side effects as such to report regarding these drugs.

Many thanks.
Richard
Expert:  Dr. Tharun replied 3 years ago.
HI Richard,

Zoladex and Casodex also known as total androgen blockade is as effective as orchiectomy ( removal of testes). They are proven to be equally effective in terms of reducing testosterone levels.

Only if the testosterone level is more than 20 ng , you can opt for orchiectomy.

Orchiectomy has an advantage of one time treatment - no need for repeated injections.Once done it is permanent and cannot be reversed.

If you have any problems in taking these repeated injections, you can always opt for surgical removal of testes.
Otherwise taking drugs or orchiectomy has equal results.

If you have any questions, please let me know.

Dr.Tharun
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