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Which ADT medication is best?
Which ADT medication is best? My medical oncologist first suggested six months of Lupron, but she was fine with Orgovyx when I mentioned that prostate patients seem to prefer it because Orgovyx wears off quickly when you stop taking the pills. But my radiation oncologist says I should do six months of Lupron injections, because the studies showing a benefit from ADT using Lupron. And he argued that some of that benefit may have come from the fact that Lupon lingers in your system and thus continues to help for a few more months after you stop taking it. For those of you who've been on ADT, I'd appreciate your thoughts about which way I should go—Orgovyx or Lupron. And if I do Lupron, do I need to take additional medications with them to deal with side effects? The medical oncologist said no additional meds would be necessary if I took Orgovyx.
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The latest NCCN guidelines state in part,
"......Relugolix shows a shorter time to to testosterone recovery, which might be associated with a higher rate of death from prostate cancer. Therefore, although the Panel considers Relugolix to be an acceptable option in the curative-intent setting, additional studies in this setting are needed....."
The sole research paper they cite for this is from 2007 and seems to address those with Gleason 8 and 9.
https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.22972
There other HUGE factor in Orgovyx is patient compliance. With Lupron, one shot and you are good for 1 - 3 months. Orgovyx you must choose to take a pill every day. That was some of the appeal for me as it gave me a modicum of perceived control in this journey even though I had no intent of stopping the 6 months of Orgovyx.
Stay Strong Brother, we got this.
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2 ReactionsA big factor in this is your Gleason score. If it is a seven then six months of Orgovyx is all that really is required by NCCN guidelines. If your Gleason score is higher than you should be on it longer, at least 18 months.
Orgovyx Works exactly the same on your body as Lupron. Other than leaving your system a bit quicker than Lupron, So if the oncologist wants you to have it in your system longer, well, then take it longer.
One thing you need to be aware of. Medical oncologist do not specialize in prostate cancer. You want a Genito urinary Oncologist to be making your decisions, if possible, They specialize in prostate cancer.
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7 ReactionsThere is a previous discussion that may be of interest https://connect.mayoclinic.org/discussion/looking-for-feedback-lupron-va-orgovyx/
A radiation oncologist at Mayo told me that Orgovyx has the advantage dissembling DNA in the tumor in addition to stopping the testosterone.
With Lupron you don't have to remember to take the pill and you don't have to decide everyday if you really should tolerate the side effects.
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1 ReactionThe link here to read is obsolete. It’s 17 1/2 years old.
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2 ReactionsI was offered Lupron but chose Orgovyx. Why? Because I wanted to be in charge the dosing scheme. If I suffered any untoward side effect, I could pull the plug at any time. With a depot injection like Lupron that's not an option. Once it's in a persons body there's no sucking it out. The patient has to weather the side effects until the drug is metabolized (months depending on the dose). Taking a tablet daily wasn't an impediment.
In a clinical setting, Orgovyx lowers testosterone and PSA quicker than Lupron. At least that's how it's promoted. After a month, things seem to even out. However, once terminated, Orgovyx clears the body quicker. This may be a good thing too.
This is anecdotal, but, in my case, I took my last dose of Orgovyx on last Thursday. Now, only five days later, I feel better and believe that I have more energy.
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7 Reactions@ecurb I understand that, yet in the NCCN guidelines that is the study they cite.
Doesn't Relugolix also drop testosterone a lot faster than Lupron? As quickly as a week is what I've read.
do you know how many new treatments have come out since then? ask Jeffmarc.....he s the expert on this forum....had PCa for 14 years. Still going strong.
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1 ReactionI've got a GU oncologist, and she was fine with six months of Orgovyx. An hour later, my radiation oncologist—her colleague—said I should do six months of Lupron instead of Orgovyx. His reasoning: Lupron lingers longer in the body, and that lingering effect might have a benefit. Hard to know what to do when two experts disagree.
Do you understand that the NCCN cited that study, and therefore their conclusion is invalid?
It is not some study I found, it is the one the NCCN based their opinion that "additional studies are needed".
What don't you understand?