Mayo Clinic Dr to guide conversation on treatment options

Have just been diagnosed with advanced prostate cancer with spread to lymph nodes. Oncologist has prescribed XTANDI and Orgovyx. Anyone have experience with these?

Anyone made the choice: Surgical castration versus hormone treatment (Lupron)?

Hi. I was diagnosed gleason 10 2 years ago. I had 45 radiation treatments and was on Orgovyx since diagnosis. PSA was undetectable with first test followng radiation. It will be 18 months on it the end of February. PSA remains undetectable, Urologist suggest 24 months, but might stop the end of this month. I have had some hot flashes, some joint stiffness, and ache in my hands. I compensate with going to the gym and staying active. I have had zero weight gain. Have continued doing all the things I did before diagnosis. Orgovyx has been great.

Welcome, @gregk92755. Here are two related discussions about those treatments:

- Enzalutamide (Xtandi): Anyone have experience with this drug?
https://connect.mayoclinic.org/discussion/xtandi-2/
- What's your experience with Orgovyx (relugolix)?
https://connect.mayoclinic.org/discussion/the-orgovyx-thread/

As you consider your treatment options, I think you might be interested in this related discussion about surgical castration or orchiectomy (removal of testicles).

- Anyone considered bilateral orchiectomy: Why or why not?
https://connect.mayoclinic.org/discussion/bilateral-orchiectomy/

@ranger44, Mayo Clinic Comprehensive Cancer Center (which includes all locations) meets the strict standards for a National Cancer Institute comprehensive cancer center, which recognize scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.

You're quite right that expertise is shared across specialties and campuses. Many members here have sought care at Mayo in Phoenix, like @jerryegge @mikewo @desip @smitty38 @spryguy @hbp @dandl48 @wrig1jam @azdave (to name a few) and can share their experiences.

You may also be interested in this related discussion:
- Choose between robotic surgery and proton therapy. https://connect.mayoclinic.org/discussion/choose-between-robotic-surgery-and-proton-therapy/

Mayo Clinic Arizona has excellent radiation facilities and experts. Have you talked to your urologist about the pros and cons of radiation vs surgery?

Hi Coleen
I have talked to the surgeon, and am meeting with the radiation oncologist 3/20/24
I am also meeting with my urologist Dr Frendl March 11th to discuss focal therapy
It seems that Mayo Phoenix is still promoting the same treatments as the last 10-20 years or more, Surgery or Radiation, take your pick. As far as radiation, I don't see where Mayo Phoenix is a center of excellence for Brachytherapy, and they don't, to my knowledge have the latest equipment like Cyberknife, they are also not up to speed on other focal therapies like the Tulsa Pro, I do believe they are doing Hifu, not sure about Cryotherapy
Bottom line is with their reputation, Mayo should be a leader and on the cutting edge of all the latest treatments and have all the latest cutting edge equipment and technologies. From what I have gathered in all of my research, the Phoenix Campus is not quite up to the level as Rochester, with the newest treatments and the leading experts in their field

This is all good info I was just diagnosed with same thing lymph node involvement in internal ileac region,waiting for rad consult. Am not thrilled after 9 years post prostectomy radiation hormone therapy first time around. Oh well I'll just hit the gym harder this time around!

I don't have an exact treatment as of now .waiting to see hormone therapy is prescribed and how much radiation I'll need. Could be two years of hormone therapy and up to 5 weeks of radiation therapy ,otherwise am in great shape.