Casodex

The cancer of prostate gland (CPG) now is one of the most widespread malignant new growths at men, borrowing 1-2 places in the morbidity rate in the USA and the Western Europe.
On the basis of the epidemiological data it was supposed, that in 2007 in the USA it will be diagnosed 223 thousand new cases of the cancer of prostate gland (CPG), and 28 590 patients will die owing to this disease. Actually the diagnosis of «the cancer of prostate gland» has been established at 230 110 patients, and in 29 900 cases the lethal outcome (ACS 2007 Statistics) has been ascertained.
Considering the urgency of the problem of treatment CPG, during the last years different variants of the combined therapy of this disease are widely discussed in the literature. One of the kinds of such treatment is the prescription of hormonal therapy during the various periods of time before radical prostatectomy (RPE) – the so-called neoadjuvant hormonal therapy (NHT).
To the lacks of the neoadjuvant treatment are referred possible by-effects of hormones on the organism, high cost of hormonal preparations, and also changes of a fabric of prostate, complicating preservation of neurovascular bunches during radical prostatectomy and essentially complicating the subsequent morphological estimation owing to medical pathomorphism. It is also considered, that after hormonal treatment even at performance of nerve-preserving operations the restoration of erectile function occurs worse.

Till now carrying out of the neoadjuvant hormonal therapy before the radical prostatectomy cannot be considered as "guide to action" (Guidelines AUA, EAU, 2004). Nevertheless, in modern conditions the neoadjuvant hormonal therapy is applied at patients both with locally spread and the localized cancer of prostate.

Casodex is applied at:

• The widespread cancer of prostate gland in the structure of the combined therapy with application of analogue of a gonadotropin -releasing hormone or in a combination to surgical castration (tablets of 50 mg);
• The localized cancer of a prostate gland at the patients, not undergone radical prostatectomy or radiotheraphy (a tablet of 150 mg);
• The locally-spread cancer of a prostate gland as monotherapy or adjuvant therapy (tablets of 150 mg) in a combination with radical prostatectomy or radiotheraphy;
• The locally-spread not metastatic cancer of the prostate gland in the cases, when surgical castration or other medicamentous interventions are unacceptable (tablets of 150 mg), in the form of monotherapy.

Collateral action

Casodex is well transferred by the majority of patients and, only in rare cases, it should be cancelled because of the by-effects caused by it.
The pharmacological effect of Casodex may cause the expected effects, including inflow, an itch, and also morbidity of mammary glands and gynecomastia which expressiveness decreases after simultaneously conducted castration. Sometimes the patients accepting Casodex, have a pain in the stomach, diarrhea, nausea, vomiting, asthenia, depression, alopecia, restoration of growth of hair, hematuria, decrease of libido and dryness of skin.
At clinical tests of Casodex changes from the liver (increase of a level of transaminase, jaundice, cholestasis) have been noted. These changes have more often carried a transitory character more and completely disappeared or decreased despite of continuation of therapy or after its termination.
On occassion on a background of treatment with Casodex the development of hepatic insufficiency is possible, thus the relationship of cause and effect between development of the given by-effect and treatment with Casodex is not established.
Besides during clinical tests at simultaneous application of Casodex and analogue of a gonadotropin -releasing hormone the following by-effects (as possible by-effects of medicamentous therapy, in opinion of clinical physicians, with frequency more or equa to l 1 %) have been noted. It is necessary to note, however, that it was not possible to prove authentically a relationship of cause and effect between these effects and the conducted therapy, except for that some of these effects often arise at elderly patients without reception Casodex.
From cardiovascular system: cardiac insufficiency.
From digestive system: anorexia, dryness in the mouth, dysepsia, contaminations, meteorism.
From the CNS: dizziness, headache, insomnia, drowsiness, decrease of libido.
From respiratory system: dyspnea.
From urinogenital system: impotency, nycturia.
From the system of hematosis: an anemia.
Dermatological reactions: alopecia, a rash, strengthening of hidrosis, hirsutism.
From a metabolism: diabetes, hyperglycemia, hypostases, increase or reduction of weight of a body.
Other: a pain in the stomach, a pain in breasts, a pain in the pelvis area, chills.

Contra-indications

• Simultaneous reception with terphenadyn, astemisol, cysaprid;
• The raised sensitivity to bicalutamide and to other components of a preparation;
• Casodex is not appointed to women and children.

Special instructions

Casodex should be applied with care at patients with moderately expressed and complicated infringements of function of a liver since at this category of patients cumulation of bicalutamide in an organism is possible. The majority of changes of function of a liver are marked during the first 6 months of treatment with Casodex. Therefore at therapy by a preparation it is necessary to supervise functions of a liver periodically. In case of development of complicated changes it is necessary to stop reception of Casodex.

Results of experimental researches

In the researches conducted on laboratory animals it was demonstrated, that Casodedx is a powerful antiandrogen and induces oxidase with the mixed functions. The changes are connected with these properties of Casodex in the target organs, including the induction of tumours at animals. At people the induction of enzymes was not observed. It is considered, that any of the results of research at animals has no direct attitude to treatment of the widespread cancer of a prostate gland people.
The influence on ability to driving and to management of mechanisms
It is improbable, that Casodex breaks ability to drive a car and other moving mechanisms.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.