Caution – The FDA Has Limited The Usage of Nizoral (ketoconazole)

Nizoral (ketoconazole, keto) is an older drug that has been used as a part of hormone therapy (ADT) for many years.  Keto, which is an inexpensive anti-fungal drug had been used for many years as an inhibitor of adrenal androgen synthesis as is abiriterone (Zytiga). Ztiga has been shown to be more effective, however, it [...]

The Well Reviewed Guide to Advanced Prostate Cancer (A Survivor Perspective) Has Been Updated and is Now Available for a free Download

Somehow I have been negligent and not let people know that I have written and posted a major update of my “Guide to Advanced Prostate Cancer.” As in the past, it is available as a free download from the Malecare web site. Helping me to update the book was prostate cancer survivor Craig Pynn and [...]

A Surprising Biochemical Response to Ketoconazole In Post-Chemotherapy mCRPC Men When Compared to the Zytiga Trial Results

It has always been assumed that Ketoconazole, when used for the treatment of men with metastatic castration resistant prostate cancer (mCRPC), would not be as potent as abiraterone (Zytiga), but there has never been any head to head comparison to demonstrate this assumption! Ketoconazole is a less potent inhibitor of the CYP-17 enzyme, the mode [...]

Can Zytiga Be Used In Men Previously Treated With Ketoconazole: A Prospective Phase II Study

Some men with advanced prostate cancer have been given the antifungal treatment Ketoconazole (Keto) as a second line hormone treatment. Like Keto, this newer hormone treatment that is now available, Abiraterone acetate (AA) (Zytiga) works by inhibiting CYP17, the rate-limiting enzyme in androgen biosynthesis. The question being asked, if Keto has failed ,given its similar [...]

A Caution About Yesterday’s Post About Combining Treatments with Chemotherapy

My post to this blog that was written yesterday indicated that for certain men the early use of chemotherapy (docetaxil) could provide significant life extending benefits, especially for men with very advanced prostate cancer. For the purpose of clarification, in this case early use means in men who are still hormone responsive. Given that chemotherapy [...]

The Differences in Ketoconazole & Abiraterone (Zytiga)

Zytiga  (abiraterone acetate) and Ketoconazole (keto) are both widely used in prostate cancer therapy to treat men with advanced prostate cancer.   They both have a common mechanism of action, they both work by inhibiting the enzyme CYP17 that is responsible for androgen biosynthesis (creation).  Inhibiting CYP17 lowers testosterone levels, which results in prostate cancer tumor regression. Because [...]

Xofigo – Designed to be Used with the Best Standard of Care Treatments

Most of the newly approved drugs and treatments for men with advanced prostate cancer are designed and approved to be used independently of other advanced prostate cancer treatments, other than with the continuation of standard androgen deprivation therapy (ADT). The newly approved drug, Xofigo, is different. It has been designed to supplement, or actually go [...]

No Difference In Ketoconazole Response For Men With Advanced Prostate Cancer Post Chemotherapy Failure

The use of Ketoconazole (Keto) in men with advanced prostate cancer is not considered mainstream, however there is clear evidence that it does reduce PSA in men with castrate resistant prostate cancer. Currently, most men with advanced prostate cancer who do use Keto utilize it prior to chemotherapy. There has been little literature evaluating the [...]

More About Dosing Ketoconazole

There are two different dosage levels used for the administration of Ketoconazole (Keto), a commonly used 2nd line hormone deprivation drug used after the failure of the traditional drugs (Lupron, Zoladex etc.). Low dosage keto involves taking 200 mg three times a day (600 mg per day), while high dose keto uses 400 three times [...]

Ketoconazole – How To Take It So That It Works

Recently, I received two separate questions about both low dose ketoconazole (LDK) and high dose ketoconacole (HDK). For both of these men with castrate resistant advanced prostate cancer, their PSA scores continued to rise, despite their using keto. Even when taken properly, not all men experience a positive effect from the drug (a decline in [...]