I'm 75 and had similar experiences. Diagnosed in 2015, a prostatectomy, followed by 37 rounds of radiation treatments. I was good until the PSA began to rise in 2021. In December of 2023, the PSA hit 2.9 and I began Orgovyx in January 2024. It knocked down my T below 7 and the PSA is undetectable.

The only side effects I've had are lack of sleep, weight gain (15 lbs) and hot flashes 24x7. Mayo had me try gabapentin for the hot flashes, but, it does nothing for me. My PSMA PET scan in January was negative.

Regarding the cost ... yes it's expensive. I receive my Orgovyx directly from Mayo Clinic in Rochester via FedEx. I believe my initial couple of months was $980/mo. I assume you're on Medicare(?) You'll hit the donut hole and then go into the catastrophic range on this med .... which is where I am right now. This means the cost is zero dollars for me for the rest of the year. As you said, it's a price well worth the cost.