My case is somewhat comparable to yours: I'm 75. GGIII, (4+3), cT3b, SVI, Decipher score on order. I would have said I'm in excellent physical shape and excellent health. The RO is ordering RT. I don't know exactly what he's going to fry. The medical oncologist I saw recommends ADT for 2 years.

I'm agreeing to the radiation and starting on ADT. The oncologist seemed about to suggest Lupron, but I expressed enthusiasm for Relugolix (Orgovyx®). He agreed, saying something about he tends to suggest what he's been using for years as opposed to the latest shiny new drug. My drug insurance will very likely approve.

(I keep in mind that when I'm participating in one of these "shared decision making" treatment decisions, I am by far, the least informed person in the room. I wouldn't doubt that is the case here as well).

My thinking on the orgovyx is that it is a daily dose pill as opposed to an injection that lasts for months. So I can start on it and if I decide I'd rather face whatever increased risk is associated with only getting 1 month, or 6 months compared to 2 years of ADT in my case rather than live with whatever side effects I can't overcome somehow, I'll just stop taking the pills. I also liked the indications that it can be a much quicker recovery coming off orgovyx than recovering from the injections.

Whatever my fears about ADT are, I'm willing to go on it and see how it goes.

I like the aspect of ADT that it can stop prostate cancer from developing. I don't like hearing things, from one nationally known urologist for instance, who said: "ADT wrecks old men's lives. We all know that", when he was addressing an audience of urologists. I do like hearing about guys who are living with it and surviving well.