Is ADT ever used moderately?

I really never see anybody saying their PSA is zero. Occasionally, you will see < .001 But that is not very common.

There isn’t really a way to reduce ADT dosage. The shots last a certain amount of time and give the same amount of the drug Each day. You could alternate Orgovyx, But you probably would end up with your testosterone down really low no matter what.

If your purposes is to not have your testosterone go down so low, you could get on a Lutamide Drug like Darolutamide Which can work even if testosterone is high.

After radiation, the PSA doesn’t go down immediately for a lot of people. And for most it doesn’t even go down to < .001 . Mine did go down to < .1 3.5 months after radiation, but I never had an ultra sensitive test to tell me if it was any lower. I do know that some people have taken up to three years before their PSA hit rock bottom after radiation.

ADT usage is based on other things. How high is the PSA?, Are there other aggressive features in the biopsy? Has there been a reoccurrence that requires radiation? Has the cancer spread beyond the prostate?

If someone had a very aggressive case of prostate cancer, they would generally put them on ADT before the PSA got down to the lowest level after radiation. Some people say no to ADT.

@jeffmarc “ You could alternate Orgovyx, But you probably would end up with your testosterone down really low no matter what.”

If the end result (low testosterone) was the same, could you reason that toxicity might be reduced?

Has anyone ever just taken the pill every second day? I presume some people have but haven’t heard any reporting on it.

@ozelli
I’ve never heard of anyone trying to do that. The half-life of Orgovyx Is only 25 hours so it would leave the system quickly, but it would suppress the testosterone every time it was taken, and that would just be cumulative. It would probably take longer for the testosterone to get down, but it would do the same thing over time I suspect.

If someone doesn’t want to mess with their testosterone, lutamides can work with it. I know quite a few people on Darolutamide alone and it keeps their PSA down.

@jeffmarc I would presume a lower dosage is possible, shots or pills.

My guess would be that this is not an unreasonable thing to do but that frequent monitoring and dose adjustment would be required and no provider wants to do that much work.

But it could at least be evaluated in studies.

(heck, start with rats, or whatever they use!)

I see ADT has been used for decades or longer, depending on what you count, and in all that time, no studies?

It might fail, but living with milder side-effects might be a winner at least for some, of course it depends on all the metrics I see people talking about and then actual monitoring and adjustment for each specific case.

My questions are colored by my experiences with other drugs for other conditions where the standard dosing has often turned out to be too high for me or the optional higher dosing has increased side-effects but not been any more effective.

I have been off adt ( Oorgovyx/zytiga) for 9 1/2 months. Testosterone gradually rising to 173 then 110. I have become accustomed to wimpy low T. I also wonder about adt lite to keep it low without full side effects of adt.At stage 4 Gleason 9-10 I really don t want to risk normal T levels for fear of reigniteing pc. One poster mentioned estrogen patch but growing a set of boobs is the downer in that idea.

@jeffmarc
Darolutamide sounds interesting ... but side-effect profile looks similar to Orgovyx. I guess not much point in having testosterone if it's blocked everywhere.