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Breast growth with bicalutamide and tamoxifen

User
Posted 06 May 2020 at 06:32

Strange that they don't mention breast bud RT at all, Lyn. It worked really well for me and was only two sessions, so I can't imagine it's a very expensive treatment. Even if it does only have a 50% success rate, that's 50% fewer surgical procedures that would be needed! 

Chris

Edited by member 06 May 2020 at 06:35  | Reason: Not specified

User
Posted 10 Jul 2020 at 18:52

I'm quite surprised reading about all this and it makes me wonder if my hospital's Oncology dept. knows anything about anything at all! I was put on Bicalutamide for four weeks and two weeks into it, was started on Prostap 3 injections, which I am still on. I was told that the Bicalutamide would stop any breast growth, which could be caused by the HT implants. (I was supposed to go onto implants, but my surgery said that they preferred giving injections, hence the Prostap 3). Unless I heard something wrong and have explained this the wrong way around maybe? But I have had no breast growth at all, not a jot, which I am glad about. Maybe it's dependent on each individual's case? I don't know, but nor have I had any side effects from either medication, with certainly no fatigue at all. As to hot flushes, I occasionally (once a month) feel like I'm glowing, as though it's a really hot day, without it being hot, but that could just be me, I really don't think it's a side effect. Sorry to butt in here, but just thought I would add my case, if it's of any interest to anyone.

User
Posted 10 Jul 2020 at 21:14
Bicalutimide is more likely to cause breast growth; it is less common with Prostap and Zoladex so if you were only on the bical for 4 weeks, you shouldn't have a problem, Ross.

Have you had your testosterone tested while you have been on the Prostap?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 10 Jul 2020 at 21:21

Bicalutamide doesn't stop breast growth, quite the opposite - it tends to cause it, but not if only taken for a month.

The bicalutamide is an anti-androgen and blocks testosterone from getting to the androgen receptors (AR), so in effect, it stops your body from being able to use testosterone.

It's given because when you start taking Prostap (or any other GnRH Agonist, such as Zoladex or Decapeptyl), for first couple of weeks it causes a testosterone flare, before switching off testosterone production from around week 3. The bicalutamide prevents the cancer cells (actually all cells in your body) from being able to use testosterone during the flare.

(Bicalutamide is also used as a hormone therapy in its own right.)

User
Posted 12 Jul 2020 at 20:31
In my case the breast growth didn’t really kick off until I’d been on bicalutimide for nearly a year. It’s extremely unlikely to occur after only four weeks.

Best wishes,

Chris

User
Posted 15 Jul 2020 at 16:24

Well they obviously told me things the wrong way round again! I've never had a single Testosterone test Lyn, just PSA tests. But nothing much has happened breast growth wise, thank goodness! Having just finished my Radiotherapy last Tuesday, I'm noticing that 'glowing' sensation quite a bit more now, it's happened four times in the last week, so no doubt IS a side effect! Must be caused by the RT somehow? As I've never even noticed it before.

User
Posted 15 Jul 2020 at 20:58
Hot flushes are a common side-effect of the HT, Ross. Nothing to do with the RT.

Best wishes,

Chris

User
Posted 18 Jul 2020 at 18:43

Originally Posted by: Online Community Member
In my case the breast growth didn’t really kick off until I’d been on bicalutimide for nearly a year. It’s extremely unlikely to occur after only four weeks.

It took 3 months for me. Agree it's not going to happen in 4 weeks.

User
Posted 09 Feb 2021 at 21:48

Well, I’ve now gone from feeling positive to depressed... why?

I spoke to my oncologist today, going through the process of deciding what treatment to take for my pc. Intermediate, Gleason 7 (3+4). 
It was explained to me that the brachytherapy (for me) would work best with ht treatment, that being bicalutamide 150 1 per day, + tamoxifen 20mg 1 tablet twice per week. It was explained that the bic blocks testosterone, and the tam stops boobs growing.... so I left thinking ht does not sound that bad.

then I read all these messages about these hormone drugs and now I’m feeling sick.... I seriously do not know what to think or do now.....

is anyone out there doing ok on ht and brachytherapy?

User
Posted 09 Feb 2021 at 22:20

Yes quite a few on this site have either had or are currently on HT. First thing to note is that you will almost certainly be on it temporarily. Ask how long they think you will be on it, two years is a common time but it could be as short as six months, sometimes it is three years. Sadly if your cancer were incurable (which yours is not) then it can be for life.

I'm slightly surprised that it is bicalutimide that is usually only for the first month and is then followed by three monthly injections of Zoladex or another drug.

Anyway I didn't find two years of HT to be dreadful, having said that I'm glad to be off it. 

Dave

User
Posted 09 Feb 2021 at 22:34

Hi Dave... I’ve been told 3 months for the hormone therapy, then seed implants while continuing with the ht.. so total time on ht is 6 months (also told radiation will die out in 3 months).

the total time for my ht bracket treatment is 6 months and been told all the effects will be over after maximum of 9 months....

User
Posted 09 Feb 2021 at 22:35
Being on Bicalutamide and Tamoxifen is ENTIRELY different from being on castrate level injectable hormone therapy. Yes Bicalutamide is a type of hormone therapy but for many much much softer with far less side-effects. I had Bicalutamide for 11 months along with Tamoxifen but fatigue was the main issue and that was only acute for a few weeks. Yes I had breast soreness but zero growth. My libido didn’t suffer in the slightest. I can’t gauge erectile function as it was so soon after surgery that I didn’t have recovery anyway.

To make it clear , Bicalutamide is HT , but it slightly lowers testosterone, but mostly hides testosterone from the cancer. Injectable HT is different and is the equivalent to having your testicles removed - it simply stops all testosterone production and so starves the cancer entirely. Many people cope fine on Bicalutamide and Tamoxifen, whereas injectable HT is way more serious. Hope this helps and good luck

If life gives you lemons , then make lemonade

User
Posted 09 Feb 2021 at 22:53

I don't think you should worry about 6 months on bicalutamide. The side effects are less than for the injectable HT drugs, and the recovery faster. Taking the Tamoxifen from the beginning will probably prevent any breast tissue growth or pain. Bicalutamide did stop nocturnal erections for me, but not erections on demand - you must remember to have erections on demand if you aren't having nocturnal erections. You can try also asking for PDE5 inhibitors (Tadalafil is a good choice for this case).

Bicalutamide actually pushes your testosterone up by around 50%, but this doesn't matter as all the androgen receptors are blocked, so it can't be used.

(Androgen = collective name for all male sex hormones, of which testosterone is the best known.)

User
Posted 10 Feb 2021 at 06:20
I was diagnosed last March Gleason 3+4, but right margin threatened (Ie close to edge and danger of breakout) so urologist said early treatment advised and he wanted me to have HT as a COVID stopgap measure.

GP prescribed short burst of Bicalutimide then Zoladex. I thought side effects sounded dreadful and deliberately delayed start until I knew what was likely.

I wanted Brachytherapy, and was lucky to get fast phone consultation with consultant. As soon as I mentioned Zoladex, she virtually erupted “no, no, not Zoladex, not Zoladex ” explaining that as a short term measure it was likely to have “undesirable permanent consequences”.

Her letter to GP said treatment should be Bicalutimide + Tamoxifen + Sildenafil, but she didn’t say I HAD to have HT, inferred the delay till treatment due to Covid might be short.

I was lucky. Brach appointment offered very quickly and treatment done only a few weeks later (I suspect I got a slot due to a cancellation but my refusal of HT may have helped).

I was told that if my prostate had been enlarged they might need to use HT to shrink it (if enlarged, bones can get in way of procedure.) But as my prostate wasn’t enlarged, I didn’t need HT.

Do you know WHY you need HT? I would have accepted the Bicalutimide cocktail for shrinking reason.

User
Posted 10 Feb 2021 at 08:22
I was on bicalutimide for 18 months in total, and the side-effects weren't too bad. Yes, as this thread says, after about a year I started getting some breast growth, but two zaps of radiation to the chest stopped that. If you're only going to be on bicalutimide for six months, and you're taking tamoxifen alongside, that's not likely to happen to you. Don't get depressed about it - you're on a curative treatment path and you'll get through it.

Chris

User
Posted 10 Feb 2021 at 08:42

Hi stead, I was told that to have the best possible outcome for brachytherapy was to have the bicalutamide and tamoxifen to start, first 3 months. Then continue after seeds placed, so total 6 months.

In fact, the consultant said those two drugs are worth about 10% improvement to the brachytherapy, and was pretty adamant that she would not offer the brachytherapy on its own!

it’s very reassuring what you have explained, so thank you for that...

User
Posted 10 Feb 2021 at 08:44

Thanks Chris, for taking the trouble to reply and advice, much needed, I can tell you!

User
Posted 10 Feb 2021 at 08:47

It's just the hormone therapy (Bicalutamide) which gives the improvement in outcomes.

The Tamoxifen is just to avoid a side effect of the Bicalutamide.

User
Posted 10 Feb 2021 at 09:12

Thanks, Andy! I was not expecting those two drugs to be part of brachytherapy, so I didn’t have questions ready at the time of my consultation. Then I read the posts that really were not relevant to my situation, which resulted in me going to bed filled with doom & gloom.

You, and the other guys like your kind self, have got me back on track this morning... thank you so much!

 
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