Adding a second medicine question

Posted by pjsatz @pjsatz, 2 days ago

I am told by doctors they would like to add second medicine to Orgovyx which I have been doing ok on for about 2 1/2 months. They say I could stay on Orgovyx only but there is possible benefit to adding a second one. I did not do well on abiraterone and prednisone, had bad headaches. If approved I could try Yonsa with a different type of steroid. I could try one of the androgen receptor inhibitors. Is it worth taking an androgen receptor blocker when my testosterone is around 10 ng/d and psa has dropped a lot?

A second drug could possibly help with delaying disease resistance. But it can also encourage some types of resistance. I don’t know that there is a definite answer here but just looking for any ideas or experiences in a case like this.

Thanks,

Phil

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lsk1000 | @lsk1000 | 17 hours ago

In reply to @pjsatz "Thank you, seems like one of the best combinations in many cases." + (show)

Thank you. Makes my spirits soar to hear that.

ga73ds | @ga73ds | 15 hours ago

In reply to @jeffmarc "After all this time, if your PSA has remained < .01 For over a year, stopping..." + (show)

"Close to 70% of people with PC are cured or at least go into long-term remission." I hope and pray you are correct. With Stage 4a, Gleason 9, and Decipher .99 at diagnosis its been hard for me to be positive. I've had removal + radiation + ADT (Orgovyx 29 months). Although my PSA has been < 0.01 for 25 months now post radiation, It's scary to risk coming off ADT. But, someone else on here said that maybe the "PSA trajectory" has been changed. I know I probably need to come off ADT to see what will happen, but that's scary.

boniyabes | @boniyabes | 14 hours ago

In reply to @northoftheborder "The -lutamides (Apalutamide, Enzalutamide, and Darolutamide) are newer than Abiraterone and don't require a steroid, if..." + (show)

Is the ADT you are now taking is Orgovyx?

northoftheborder | @northoftheborder | 7 hours ago

In reply to @boniyabes "Is the ADT you are now taking is Orgovyx?" + (show)

Yes. Firmagon for the first 2½ years, then Orgovyx (basically Firmagon in pill form) for the past 14 months.

Orgovyx has been a real game changer compared to getting the injections — my body's much happier with a daily microdose than it was being whacked with a monthly megadose.

jeff Marchi | @jeffmarc | 2 hours ago

In reply to @ga73ds ""Close to 70% of people with PC are cured or at least go into long-term remission."..." + (show)

Yes, your cancer is a high risk cancer. The thing is, you’ve gone 2 years with undetectable PSA. Can’t hurt to stop for one month to see if your PSA starts rising.

In my case, after almost a year of undetectable, I reduced my Zytiga From four pills to three to see if it would help with brain fog. In 18 days, my PSA went from .2 to 1, Back to four pills right away. I have BRCA2 Which causes real problems with prostate cancer growing from time to time. So in my case, I can’t stop the drugs without my PSA rising.

I know a lot of people with Gleason nine that have stopped taking the drugs and been able to do it for quite a long time, Over a year, Before their PSA started to rise in most cases.