What's your experience with Orgovyx (relugolix)?

Has anyone tried the new “Patch” that is out there , that is supposed to be the NEW hormone therapy ? If so how did it work. My Urologist never heard of it.

I’ve been on Orgovyx for about 2 months. My PSA has become undetectable . The main side effect I’ve experienced is hot flashes a couple of times/day for a few minutes. To me it’s an annoyance but a small price to pay considering the benefits. I hope guys won’t be scared off by the list of possible side effects which, for legal reasons , must be all inclusive. Most men will not experience many of them. Some might. One advantage of Orgovyx over injected hormones is that you can always stop if you are unlucky enough to have bad side effects.

I'm 1-1/2 months in Orgovyx. I woke up 4 times after midnight feeling a little bit hot in the body and cold legs as if they were a little wet for a couple minutes, and then I would be okey as if nothing happened. My worst experience to date.
I finished my SBRT treatment 18 days ago; my oncologist said that my immediate side effects would probably peak around the third or fourth week. I will see what happens next week. After that I hope things will get better.

Layperson reponse: Both injectable Eligard or oral Orgovyx are recommended therapies. Insurance coverage may be more comprehensive for Eligard (Medicare Part B and Medicare Supp, if applicable) vs Orgovyx Tier 5 Medicare Part D coverage. I am beginning 4 mos of Orgovyx Friday, with 38 radiation txs beginning Jan 13. Orgovix has a slightly better cardiac risk profile to Eligard (think 3% vs 6%, not positive). Obviously, choice is yours to make with your MDs. Good luck.

general

@michaelcharles I hope you’re still active or will be notified about this question. My husband had Gleason 9, 4+4, RP but PSA never came down to undetectable. At first PSA follow up it was 1.5. Then 1.9, 2.0, and 2 months later 2.4. Plan for Radiation IBRT at Mayo FL for 38 sessions for prostate bed and lymph nodes. Despite PSMA PET and MRI showing nothing. Assuming micro metastasis. RO also ordered 6 months of Orgovyx. Can you tell about some side effects?
was fatigue horrible doing both rad and ADT at same time?
What about gynemastisis (breast enlargement)?
Husband’s radiation is every day at 1:30 p.m. Should he take ADT in morning to get over hot flashes before driving 1:15 to treatment?
Any other suggestions? He is active doing household chores and fixing things, but should he be walking for exercise? Weights? He’s thin already, and the MiraLAX for radiation prep is already causing issues. Concerned about how to feed him healthy to stave off fatigue, a low gas. Foods. Any suggestions?

Orgovyx cured my metastatic prostate cancer.; took for 2 yrs; clean bill of health 5/10/2023.CT CHEST ABDOMEN PELVIS W CONTRAST

Details
Study Result
Narrative
EXAM: CT CHEST ABDOMEN PELVIS W CONTRAST

INDICATION: stage 4 prostate cancer, known nodal metastesis, repeat staging, access for treatment response

COMPARISON: Multiple prior CT scans. The most recent is the torso CT from 05/23/2022. Whole body bone scan 01/20/2021

TECHNIQUE: CT axial images of the chest, abdomen and pelvis were obtained during intravenous administration of 100 mL Omnipaque 350. Sagittal, coronal and MIP reformatted images were obtained and reviewed.

ORAL CONTRAST: Positive oral contrast was administered.

FINDINGS:

CHEST: Two micronodules which appear calcified (304:139 in the posterior left lower lobe and posterolateral right lower lobe 304:180) are stable and almost certainly incidental. No suspicious pulmonary nodules. An area of scarring in the medial left
lower lobe is stable. Trachea and mainstem bronchi are normal. No consolidations or effusions.

Normal thyroid.

The heart is not enlarged. No pericardial effusion. Nonaneurysmal aorta. Mild coronary artery calcifications.

No mediastinal, hilar or axillary adenopathy.

Normal thoracic esophagus.

ABDOMEN/PELVIS:

The liver is normal in size and morphology containing no suspicious lesions. The gallbladder contains a few small stones which layer dependently. Normal spleen, adrenal glands and pancreas. The left kidney contains a few scattered simple cysts which are
stable. No hydronephrosis.

The bowel is unremarkable with no evidence of obstruction or wall-thickening. Possibly the stump of the appendix is seen on coronal image 60. This is not inflamed.

Pathologic adenopathy in the pelvis and retroperitoneum has not recurred. Left external iliac node measures 7 mm ((303:201) and is stable. No growing lymph nodes are appreciated.

The bladder is unremarkable. The prostate is not well assessed but appears grossly normal.

No ascites. No peritoneal nodules.

Small fat-containing right inguinal hernia. A knuckle of small bowel protrudes into this but it is not inflamed.

Hepatic veins and portal venous system are patent. Focal moderate stenosis of the proximal 2 cm of the SMA secondary noncalcified atherosclerotic plaque (602:73). This has progressed. The lumen in this area has narrowed from 7 mm to 4 mm since 2021

MUSCULOSKELETAL: Left total hip arthroplasty prosthesis is intact. A subcentimeter sclerotic focus in the right lateral sixth rib is stable and did not demonstrate uptake on whole body bone scan. Most likely this is a small bone island. No suspicious
osseous lesions.

IMPRESSION: Stable exam. No pathologically enlarged pelvic or retroperitoneal lymph nodes. No convincing evidence of osseous metastatic disease noting a whole body bone scan is pending.

Moderate stenosis of the proximal SMA secondary to noncalcified atherosclerotic plaque. This has progressed relative to 2021. Since that time the lumen in this segment has narrowed from 7 mm to 4 mm.
Details
Study Result
Narrative
EXAM: NM BONE WHOLE BODY

INDICATION: stage 4 prostate cancer, known nodal metastesis, repeat staging, access for treatment response STUDY NOTES: 20.6 mCi MDP in RAC

COMPARISON: CT chest and abdomen/pelvis 5/10/2023. Bone scan 1/20/2021

RADIOPHARMACEUTICAL: 20.6 mCi of Tc99m MDP IV.

TECHNIQUE: Following radiotracer administration, standard whole body bone scintigraphy was performed.

FINDINGS:

There are no uptake abnormalities suspicious for osseous metastatic disease.

Periarticular uptake in the shoulders, wrists and left ankle is typical in appearance and location for degenerative change. Additional focal uptake in the posterior thoracic and lumbar spine is favored to reflect degenerative change.

Renal, bladder and soft tissue uptake are physiologic

IMPRESSION:

No specific evidence of osseous metastatic disease.

As an "older" military retiree, I am covered by Medicare and Tricare for Life. I am scheduled for 9 weeks of Proton radiation therapy. Both the radiological oncologist and my regular urological oncologist think the best course for me is to have a month or two of Orgovyx before starting the proton therapy and continuing it during the proton stuff, for a total of 4 months ADT on Orgovyx. When my oncologist submitted the request for pre-authorization, it was denied. In the opinion of ExpressScripts, the governing body in my case, the diagnosis was not cited as a category 1, 2A and 2B recommendation as listed in the National Comprehensive Cancer Network (NCCN) guidelines. Has anyone out there experienced anything similar, and successfully appealed such a finding?