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Prostate Cancer | Last Active: Oct 17 2:02pm | Replies (39)
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In order to stop the Lupron PSA surge they give you biclutamide for two weeks before Lupron and then you don’t get the surge.
Your doctor should’ve known that, but urologist don’t know all that much compared to some oncologists.
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A radiation oncologist in my case, in consultation with a medical oncologist, both at the Cancer Centre.
My memory's a bit hazy because I was in critical care recovering from 10+ hours of emergency spinal surgery with paralysis and a range of serious post-op complications (including an inability to eat), but I suspect they didn't want to wait two weeks or to introduce another drug— they needed to get my T down immediately, and in their experience, Firmagon was the best bet in my specific case. I suspect they were right: in the event, it reduced my PSA dramatically in a few weeks (from 67 at diagnosis), and brought it to undetectable in a couple of months.
And after that, with Firmagon+Apalutamide controlling my cancer so well, it wouldn't have made sense to risk switching until Orgovyx — another GnRH receptor antagonist, like Firmagon — became available here.
In any case, the outcome has been good. I just passed my 3rd anniversary yesterday, with no detectable recurrence.