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Urologist only offers Degarelix or Eligard, so what....

Posted by johnt0707 @johnt0707, Mar 13 12:31pm

Urologist only offers Degarelix or Eligard, so what am I missing that she's convinced these injectables are the only way to go for recurrent PC after 43 rads, limited so far to the P; gleason of 7. It's her way, nothing, or find another provider, which is not easy in my area. I'm wanting to consider Orgovyx, for example.
Thanks for your insights!

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johnt0707 | @johnt0707 | Mar 21 6:07pm
In reply to @rex5789 "see an oncologist/" + (show)
@rex5789

see an oncologist/

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That is my next step, thank you. I guess I reached the trigger point when your switch from urologist to oncologist.

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johnt0707 | @johnt0707 | Mar 21 6:11pm
In reply to @gently "Orgovyx is newer, your urologist is using what she has had success with. I've spoken with..." + (show)
@gently

Orgovyx is newer, your urologist is using what she has had success with. I've spoken with oncologists who say that he advantages with orgovyx are many, but they just haven't changed their practice, yet.

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I'm sure that's occurring. I'm also certain that the payment methodology for injected medications that need special handling are more favorable to urology clinics than watching for possible reactions to expensive, take-yourself, by-mouth medications.

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johnt0707 | @johnt0707 | Mar 21 6:14pm
In reply to @round5 "My gut feeling tells me that those medical providers against Orgovyx is because they know their..." + (show)
@round5

My gut feeling tells me that those medical providers against Orgovyx is because they know their injected patients are compliant and they really don’t know with the Orgovyx. After working 25 years as a nurse and seeing the elderly in my own family being very noncompliant with their medication’s I would probably have to agree..

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Totally agree with you. Finding a provider who recognizes when patients have the critical thinking and physical ability to be active in their own care has always been a challenge in the MD world.

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northoftheborder | @northoftheborder | Apr 11 1:05pm
In reply to @brianjarvis "There are known and documented side-effects with all ADTs. Some are “possible” while others are “likely.”..." + (show)
@brianjarvis

There are known and documented side-effects with all ADTs. Some are “possible” while others are “likely.” Always focus on the “likely” ones. Most men experience some of these side-effects of hormone therapy to varying degrees — some more, some less —> forgetfulness, confusion, memory loss, mood swings, emotions, fatigue, loss of libido, ED, insomnia, hot flashes, night sweats, muscle atrophy, weight gain, and more….

There are ways to minimize many of these side-effects. Here are videos from recent PCRI conferences about ADT and the physical benefits of exercise:


As for your arthritis…. Similarly, my bone scans, though they are negative for metastatic disease, show (what I could have easily told them) that I have “….degenerative changes in lower lumbar spine and multiple joints (shoulders, sternoclavicular joints, elbows, wrists, knees, ankles, feet, right humeral shaft….likely non-specific and represents a benign process).” Basically, my sports injuries from football, track, gymnastics, and more…..many decades ago have all come back to haunt me now in my 60s.

Still, I push through it because I have to; no excuses.

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I agree that resistance-training is a very good idea — everyone should follow the advice in this video if physically able — but based solely on personal experience, they overstate the consequences a bit (understandably, because even physicians aren't immune to riding a hobby-horse).

My PC diagnosis was accompanied by paraplegia from the mid spine down (the tumour had compressed my spinal cord), so I wasn't able to do the kind-of complete resistance program they described for many, many months. Certainly, my leg and core muscles atrophied a fair bit (because they were getting almost no nerve signals at all initially), and using my arms to pull myself from side-to-side in the hospital bed gave me some upper-body resistance work, but I didn't see anything like the dire effects they describe during the period when I was starting to become mobile, but couldn't yet get onto the floor or a weight bench for full resistance training.

I did do physio exercises in bed to the best of my ability, and I'm keeping them up now that I'm more mobile, but they were far below the level of weights or push-ups, and I doubt the claim that taking just a 4 week break from 3×/week resistance training would result in massive muscle loss on ADT (at least at my age, mid-50s at the time).

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brianjarvis | @brianjarvis | Apr 14 8:32am

There will always be outliers and exceptions. But, study after study demonstrate the benefits. Here’s a recent study about the benefits of exercise to counteract the adverse effects of ADT: “Resistance Exercise Training Increases Muscle Mass and Strength in Prostate Cancer Patients on Androgen Deprivation Therapy” —> https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

If for one reason or another, one can’t engage in that level of activity, well….such is life. But, the data are there for anyone to use should they choose to.

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1 reply
johnt0707 | @johnt0707 | Apr 14 2:14pm
In reply to @brianjarvis "There will always be outliers and exceptions. But, study after study demonstrate the benefits. Here’s a..." + (show)
@brianjarvis

There will always be outliers and exceptions. But, study after study demonstrate the benefits. Here’s a recent study about the benefits of exercise to counteract the adverse effects of ADT: “Resistance Exercise Training Increases Muscle Mass and Strength in Prostate Cancer Patients on Androgen Deprivation Therapy” —> https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

If for one reason or another, one can’t engage in that level of activity, well….such is life. But, the data are there for anyone to use should they choose to.

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Helpful research and thanks, hopeful the needed energy will be there.

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