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ADT and Castrate Resistance
Diagnosed Nov 2021. Gleason 9, Decipher .99, stage 4a (spread to seminal vesticles and 1 of 12 lymph nodes tested). I had prostatectomy in January 2022. There was some positive margin. I started ADT (Orgovyx) a year later in January 2023, a few months prior to pelvic radiation in March-May 2023.
So, I've been on ADT (Orgovyx) for 2 1/2 years total-- 2 years since radiation. Since radiation and while on ADT, for over 2 years now, my PSA has remained undetectable at < 0.01. I am very pleased.
My question-- is castrate resistance more likely the longer you stay on ADT? If CR develops, I read that the prognosis is not good.
My doctors want me to come off the ADT. I'm not convinced I understand why. I'm reluctant. I've so far had no serious side effects from the ADT (Orgovyx).
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@barblouise
Actually, that isn’t true. They’ve been studies done and one of the people in this forum is in one of those studies taking Apalutamide. The studies have shown that people who take ARSI along with ADT can delay the time to castrate resistance.
You can search it yourself using this search “ can taking an ARSI along with ADT delay the time to castrate resistance”
From AI
Yes, combining an ARSI with Androgen Deprivation Therapy (ADT) can delay time to castration resistance by improving outcomes in metastatic castration-sensitive prostate cancer (mCSPC). Clinical trials have shown that adding an ARSI to ADT leads to significant improvements in radiographic progression-free survival (rPFS) and overall survival (OS), effectively prolonging the period before the cancer progresses to a castration-resistant state. This combination therapy is now a standard-of-care treatment for patients with advanced prostate cancer.
Here is one of a few references
https://link.springer.com/article/10.1007/s10147-024-02670-5