I have stage 4a metastatic prostate cancer, where tumors have been found outside my prostate in lymph nodes in my lower abdomen. I was prescribed Casodex about a year ago and 30 days later was changed to Lupron and Xtandi.
My PSA levels have responded well, but I lost my private insurance (and my job) at the end of February 2023 so Xtandi is no longer financially viable.
My oncology team suggested that I have my prostate and testicles removed which has negated the need to continue with my Lupron injections
It appears from my reading that Casodex and Xtandi work in the same way with Xtandi performing slightly better in some of the trials.
Since Xtandi is no longer affordable with my Medicare plan, would it make sense to replace that treatment with Casodex?
Thank you for your consideration.
Does Casodex work the same way as Xtandi?
Question posted by Sonofasailor on 6 April 2023
Last updated on 7 April 2023
To clarify:
Casodex was prescribed by my urologist, who initially diagnosed my condition following the biopsy he performed in his office. He suggested that I join a prostate oncology group at the Fred Hutchinson, Seattle Cancer care center for further treatment. The Casodex appeared to work well with my PSA dropping from 41 to 22 in a little over 30 days.
The new team of doctors decided to switch my medication’s to Lupron and Xtandi in August and my PSA continued to drop until it was measured again in December where it was reading .03.
Removal of the prostate and testicles was undertaken as a part of a separate study by the University of Washington Medical Center, and was paid for by my private insurance, which was still in force at the time. Without that study, neither the private insurance, or Medicare would have paid for it.
Answers
Click on the link for a full detailed comparison between both medications:
Casodex is a non-steroidal anti-androgen. It competitively inhibits the action of androgens by binding to cytosol androgen receptors in the target tissue.
Enzalutamide is an androgen receptor inhibitor that acts on different steps in the androgen receptor signaling pathway. Enzalutamide has been shown to competitively inhibit androgen binding to androgen receptors and inhibit androgen receptor nuclear translocation and interaction with DNA.
Source: FDA
Related topics
casodex, prostate cancer, cancer, prescription, prostate, xtandi, lymph node, abdomen, tumor
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