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Cancer: Prostate Message Board


Cancer: Prostate Board Index


Hi Irv,

You're welcome, and I admire your perseverance and success in getting on triple blockade and reaching the point where you can take a vacation. It's well earned!

Avodart is usually somewhat more effective than finasteride for most men, and that likely includes you as you have responded well. Which drug to use could be a judgment call depending on how satisfied you are with recovery as testosterone comes back, and what the PSA and DHT are doing. While on vacation from the heavy duty drugs, my DHT was 11 on two finasteride daily, but it dropped to 5 after a short time on one Avodart and is probably lower now. Along with the Celebrex, I credit switching to Avodart for enabling me to maintain fairly good control of my PSA after it was rising too far with just thalidomide and two finasteride daily.

Regarding Celebrex, known as a "COX II inhibitor," there is an impact on PSA for many of us, especially with a rather high dose of 2 X 200 mg daily. I started taking it again in late November after my PSA started to rise on just thalidomide and Avodart, and I believe it is a key element in keeping my PSA stable for the past few months. Of course it is known for helping arthritis patients with muscle soreness and joint pain, and I too welcome the relief it gives from muscle soreness. In the past I have had to use an NSAID like Aleve to get a good night's sleep after a gym workout or vigorous physical work, even while taking thalidomide, which is a great sleeping aid. I haven't needed Aleve at all while taking the Celebrex. COX-II inhibitors got a bad reputation for heart and stroke trouble some years back, and COX-II inhibitors Vioxx and Bextra were pulled from the market. Celebrex had a much better risk record, and the risk it does have appears to be low if the patient has a good cardiovascular profile. I had stopped taking it a few years ago when my insurer decided not to cover it, because of what was known then about the risk. Now, based on new information, the insurer is covering it again, at least for me.

Celebrex works in several ways against prostate cancer. In the lab, NSAIDs, which include Celebrex, block both androgen dependent and independent prostate cancer. They block an important pathway for cancer cell survival known as NF-kappa beta. They increase the sensitivity of prostate cancer cells to radiation. They block conversion of arachidonic acid to prostaglandin E2, which is a promoter of prostate cancer, and which may help the cancer grow new blood vessels. (Prostate cancer cells produce ten times the amount of prostaglandin E2 as do normal cells.) COX-II inhibitors also help block the formation of new blood vessels for many cancers. There is a good description of this in an old Prostate Forum, Volume 4, Number 10 (published in 1999), on page 5, including research references for these points. The discussion mentions that, because of Celebrex's effect on "p-glycoprotein", it appears that Celebrex should not be taken for a period before and after chemotherapy. I have also heard that patients allergic to sulfa drugs may run into trouble with Celebrex.

I found I was able to build muscle on blockade, but I had to do it very gradually. I tried to speed up several times but got so sore I could not sleep well. You should feel the benefits of returning testosterone soon, but it will build up gradually. The increasing level will make workouts a lot easier.

Take care,

Jim :wave:





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