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@northoftheborder

If your cancer is in an advanced stage, I would look into adding an androgen-reception signalling inhibitor (ARSI) at least. ADT is the traditional treatment for prostate cancer; adding an ARSI is how everything has changed over the past few years.

Examples: abirateron (Zytiga), enzalutamide (XTANDI), apalutamide (Erleada), and darolutamide (Nubeqa).

It used to be that they waited to add an ARSI until the prostate cancer became castrate resistant, but the big TITAN study showed that adding apalutamide (at least) to ADT earlier made a massive difference in overall survival, so much so that they had to unblind the study before it was done for ethical reasons and let the placebo group switch over.

https://www.nejm.org/doi/full/10.1056/NEJMoa1903307

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Replies to "If your cancer is in an advanced stage, I would look into adding an androgen-reception signalling..."

After reading the synopsis of the titan trial it seems conclusive that synergy is demonstrated. Do you know of any research that compares xytiga/earleda effectively ranking efficacy?

Thanks for your post. I have Adavanced Prostate cancer and have been on ORGOVYX since 2021 with excellent results. PSA 0.02 I’m not sure if it would be a good idea or worth it to add another medication since the side effects of ORGOVYX are pretty extreme now? Any comments