Yes. Still castrate-sensitive after 3 years 4 months (PSA < 0.01). The TITAN study showed that Apalutamide used together with ADT can delay castrate resistance for mCSPC dramatically compared to pairing with earlier 1st-gen ARSIs (many TITAN participants were still castrate-sensitive at the end of the 4½ year study), and I'm fortunate that I was diagnosed just as Apalutamide became widely available in Canada, so I got the full benefit. The other -lutamides are also very effective (some perhaps even more so).

What's it like on ADT in the long term? Well, you do get used to it. And Orgovyx is *far* easier than the monthly Firmagon injections that I started with. I miss my hairy chest and don't love the gynecomastia that has replaced it, but I do love that I'm not counting down my last months yet.