T and PSA levels 6 month post SBRT and 1 month post Orgovyx

Post treatment, my PSA is tracking at 0.05. However, T has been slow to recover after Orgovyx, 4 months, that ended 23rd January.
Component Value Date
TES
122 (L)
06/27/2024
TES
85 (L)
04/01/2024
TES
12 (L)
02/02/2024
TES
32 (L)
09/28/2023
TES
467
06/06/2023

PSA looks great!! And the T will work its way back up.

Stay Strong Brother

I will hopefully be going on ADT retirement (as opposed to vacay) in August when I next meet with my MO. I've been on Orgo 24 months and Abi 14 months. Original plan was to continue with both until 24 on Abi but I just feel like I'm hitting a wall. Concerned about the continued battle with my blood sugar, bone health, muscle mass, cardiotoxicity, and the latest thing I've noticed - some memory loss. I think it's a good time to try. My PSA has been undetectable since soon after starting Orgovyx and testosterone initially in the teens, then down to 4.

@toolbelt How long did you take Orgovyx? I started Orgovyx two weeks before my SBRT, and stopped Orgo after six months, week and half ago.
My PSA after 3 months was 0.36 and 0.22 after six. My RO consultation is next week, and I am looking for suggestions on what questions I should ask her.
On Marchg 26, when she started me on Orgovyx, she said that I may need it for 8 months to a year. In July, after seeing my PSA down to 0.36 from 7.0 and 10.5 pre-SBRT, she said only "six months short-term ADT." I was expecting < 0.1 after 6 months, but it's 0.22 and I'm not happy about it.

I was on Orgovyx for 6 months. I was very happy with my 0.19 nadir on Orgovyx. Your 0.22 seems to me to be a good result. Don't be surprised if your PSA goes up now that you are off Orgovyx. SBRT can take 18 to 36 months to show an end result. You will see bounces along the way. Bounces are seen as a good prognostic indicator. Ask you oncologist about bounces, if she considers the 0.22 as a nadir even if it was while you were on Orgovyx (the reading on Orgovyx is generally accepted as a valid nadir until and unless you test lower). Ask about your frequency of PSA tests moving forward. Ask at what point she would be concerned. Biochemical failure is nadir plus 2.0. Ask what your options are IF you get to that point. Again, I think your 0.22 is totally acceptable.
Stay Strong Brother We Got This

Hi - I've been on orgavux for 6months , completed 28 radiation sessions mid August - 1st psa test < .01 - I had a gleason 8 with seminal vesicles also detected. Just wondering your situation - and your decision to stop in 6months. My oncologist stated 3yrs..for me. Any info would be helpful. Ty Gary

@garyhu I was low volume (1 of 12 cores) 4+3 with a high Decipher of 0.84. PSA was 7.2. We did not discuss extending the Orgovyx beyond 6 months. PSMA PET showed confined to prostate. I had a total of 36.25 Gy to the entire gland and a focal boost to the primary lesion to 40 Gy.

Appreciate the info. Ty

@toolbelt and @garyhu I was (3+4) on 4 cores and (2+0) on 4 other cores. Total 8 cores positive out of 14 made me unfavorable intermediate. I believe this was why my radiation oncologist initially said I would be 8 months to a year on Orgovyx. My next consultation with the RO is next week.
With my testosterone of 0.4 in both the July and October tests (T < 20 is considered castration level), I am optimistic that my very low T will not cause a rapid doubling time (DT) of my PSA from 0.22 this month onwards. I am even hoping that it would continue to go down after I stopped ADT already.