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Husband’s low psa, aggressive Gleason 8
Prostate Cancer | Last Active: Jul 27, 2025 | Replies (35)Comment receiving replies
"Unlike other injectable ADTs, Firmagon lowers testosterone levels quickly, which should correspondingly drop PSA levels quickly."
Exactly. That's why they put me on Firmagon initially in 2021: I was in severe medical crisis (including paraplegia from rapid spinal compression) and couldn't risk the initial testosterone surge that comes with Lupron.
Now, I'd be able to go on Orgovyx instead, which works the same way as Firmagon but without the acute side-effects around each monthly injection (a few days of flu-like symptoms, swelling around the injection sites, etc), but Pfizer hadn't obtained Health Canada approval for Orgovyx yet in 2021.
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For those who don’t start on Orgovyx (because some insurances here in the U.S. either won’t cover it or won’t cover much of it), they start on Casodex (Bicalutimude) for up to 30 days. I started on Casodex.
Casodex blocks testosterone from attaching to prostate cancer cells, which prevents tumor flare when hormone therapy is started. Once testosterone levels are suppressed, the risk of tumor flare goes away.