1st PSA test seven weeks after surgery

That’s what they told me too. My surgery was May 22 so the very earliest they would do radiation was late August.

Just met my MO for the 1st time. She ordered another PSMA PET scan which I will have on July 31. She will also start me on Firmagon shortly there after. She choose that drug because she said it will lower PSA the fastest, but said I could go on orgovyx after that if I want. Does this sound like a good plan to those here with experience? What’s the probability that I will see a lot of new spread since my PSMA PET Scan on 3/27 and prostatectomy on 5/22? All 19 nodes during prostatectomy were found to be cancer free.

Firmagon followed by Orgovyx is a great way to do it. The NCCN recommends staying on ADT for at least two years if you have a Gleason 9. Your doctor can recommend the best timing for you.

There is no way to predict what will happen in the future for somebody with a Gleason nine, Or even a Gleason seven. That’s the thing with prostate cancer. Everybody is different but with no spread at all, you have a great start. Getting on ADT should stop your cancer from growing, How long is unknown.

The PSMA Pet scan will give you a better idea of what your treatment could be And what is necessary?

I know people who are Gleeson nine that are a decade past surgery, One guy in particular came into the online meeting at Ancan.org And he had a reoccurrence after 30 years, Gleason 9. Other people with the Gleason nine have the cancer spread quickly,

Thanks @jeffmarc !
Doctor told me ADT for 2 years but I was expecting she would say 3. 🙂

I had my prostate removed and afterwards psa was not detectable at 6 weeks, at 12 week it was .09 then keep going up, then radiation, at 3 months not detectable then at 6 months not detectable.

Any news from your Dr's Sir ? Your still very fresh out of surgery . With negative lymph node , thats a very good thing and they tested them too ! Did they take them out or ? How are things now ? James on Vancouver Island .

Hi James! They took out 19 nodes - 13 on the left and 6 on the right. The tumor I had was all on the left side. I will have another PET PSMA scan on July 31 and then start Firmagon for 2 years on Aug 5. My next appointment with radiologist is Aug 20, which I believe is a simulation to get me ready for radiation. Also, results of a DEXA bone scan I did last Friday came back good (as far as I can tell). They also tested my current testosterone (baseline before meds) which came in at 394.
I hope you are doing well! 🙂

You really should ask your doctor to let you have something besides Firmagon. Many people start to have a lot of pain from getting that shot every month, And the doctors love the income from having a monthly shot.

You would get the exact same results from a three month Lupron shot, And it’s in the hip and doesn’t really hurt, I got them for six years.

Even better ask your doctor for Orgovyx, A once a day pill. If you do this, when you stop, your testosterone comes back much quicker.

As we've discussed before, though, Lupron triggers an initial testosterone surge, which is bad news if the cancer has already started spreading. It is possible to suppress the surge, but it still delays the time before Lupron can start lowering your testosterone level.

Ideally, in that situation, you'd get Orgovyx, which you mentioned, but it's crazy expensive in the U.S. and not all insurers will cover it.

Since I was on Firmagon for 2½ years before Orgovyx became available here, I'll confirm everything you wrote about swelling and discomfort around the injection site, and toss in 2–3 days of flu-like symptoms every month to boot. But if (like I did) you urgently need ADT that starts working right away, and your insurer won't cover Orgovyx (or it's not approved yet in your country, which was my case in Canada in 2021), then you don't have many other options.

I’ll have to ask my MO again, but I recall her saying that Firmagon would lower my PSA the fastest but that I could switch to orgovyx later on.