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@nikolai57 Regarding the T spike —>
After starting hormone therapy (like Eligard, Lupron, etc), the body realizes testosterone (T) are slowly dropping, and tells the body to produce more T to offset the slow drop. This may cause a brief “spike” in T which can result in what is called "tumor flare” or “testosterone flare.” - not a good thing to happen since prostate cancer feeds on T.
This temporary flare can be managed by first taking Bicalutimide (Casodex) which blocks T from attaching to prostate cancer cells, which reduces the risk of tumor flare when hormone therapy is started.
Tumor flare does not last long and will go away as the T level goes further down after a hormone injection.
On the other hand, when starting with Relugolix (Orgovyx) or Firmagon, T levels drop so quickly that the body doesn’t have time to realize that T levels are dropping, thus the “testosterone flare” effect doesn’t occur.
Replies to "@nikolai57 Regarding the T spike —> After starting hormone therapy (like Eligard, Lupron, etc), the body..."
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@brianjarvis Although the results are as you describe them, the biochemical process is more complicated than that. Eligard, Lupron, etc. are T agonists that stimulate the pituitary gland to temporarily produce more T (the flare). The outcome is that the pituitary down-regulates the T receptors and T levels drop. Orgovyx and Degarelix are examples of T antagonists that bind to the receptors and block the pituitary from producing T. This results in an immediate drop in T. I’ve probably oversimplified, and I’m not a biochemist or physician, so please correct any errors in my explanation.