I've been three years on ADT + Apalutamide with bone mets as well, starting at age 56. The first 2½ years I was on Firmagon for the ADT, then I switched to Orgovyx (Relugolix) last spring.

Even though Orgovyx is essentially the same thing as Firmagon — a GnRH receptor antagonist — I've noticed a huge improvement in quality of life since the switch, as I've mentioned in other posts. I still get hot flushes sometimes, but taking a microdose in pill form every day has resulted in more mild side-effects and reduced fatigue, as well as avoiding those 2–3 sick days after every monthly shot that you mentioned and the swelling and rash around the injection site.

I hope your experience is similar. Best of luck!