Orgovyx-Start and Stop Advice

I had mine removed almost 5 years ago. My PSA has stayed at < .01. PMSA scan 2 years ago at Mayo showed no cancer. I dont know anything about the treatments but I am thinking that with removal and rising PSA, I would want to know more about whether the PET scan was accurate. Seems something is going on. I would do that before stopping any medication.

In some cases, stopping and starting, the medicine can cause it to be less effective, but that’s usually with people who have much more serious cancer cases than you have.

I know many people who have stopped taking their drugs because their PSA dropped, as yours has, and some of them have gone a couple of years before their PSA started to rise. Stopping and starting a couple of times is not gonna really cause a problem.

This is something you should definitely consider doing. Make sure to get monthly PSA tests.

One of the benefits of Orgovyx is that the testosterone usually comes back quickly. That will make you feel better, be aware that at 78 testosterone tends to rise much slower than with the younger people.

Your question is a good one to ask . And do all ADT drugs- on again- off again respond in the same way used intermittently?

I agree with your doctor. Intermittant ADT has been shown to be superior to Constant ADT in patients with biochemical recurrance. My limited understanding is that resistance occurs because the tumor devises a way to create it's own testosterone.
Stopping orgovyx looks like an opportunity to see if you need the medication and to delay castration resistance if you return to the medication.
You do have to keep careful track of your PSA.
Bless your choice.

Tumor devises a way to create its own testosterone; great statement, gonna ask my MO about this topic in October.

Like @jeffmarc , I have heard of some studies showing that "ADT holidays" (stopping until PSA rises again) have the same or slightly better overall survival for EARLY STAGE prostate cancer, probably because of the reduced risk of heart disease, diabetes, etc. That doesn't (yet) apply to advanced prostate cancer like mine.

Obviously, it's not something to try on your own, but if you discuss with your oncologist and it's appropriate for your situation (our cases are all unique), the two of you can develop a plan together.

Best of luck!

90 days after RP with PSA "persistent" at .19 and a "clean" PSA pet scan, I was treated with Salvage Radiation to the whole pelvic region and pelvic lymph nodes as the most likely location for residual PCa, together with short term ADT.
My post Salvage Treatment PSA has been < .02 for about 1 yr now.
Very grateful for the results so far. Just sharing my treatment history.
Best wishes.

90 days after RP with PSA "persistent" at .19 and a "clean" PSA pet scan, I was treated with Salvage Radiation to the whole pelvic region and pelvic lymph nodes as the most likely location for residual PCa, together with short term ADT.
My post Salvage Treatment PSA has been < .02 for about 1 yr now.
Very grateful for the results so far. Currently off all treatment.
Just sharing my treatment history.
Best wishes.

Ok Good info. I wonder what your testosterone levels are now ?

Testosterone recovered 80%.
Pretreatment 439
Currently 340 range (3 most recent tests).