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← Return to prostate cancer ADT injection
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Prostate Cancer | Last Active: 9 minutes ago | Replies (14)
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@brianjarvis We chose Firmagon at the time because my PSA was high (nearly 68) and the cancer was aggressive (it had already spread to my spine), so we couldn't afford the initial testosterone surge that many other types of ADT cause.
In 2021 Orgovyx wasn't available yet in Canada, unfortunately, but since it's a GnRH antagonist just like Firmagon, it was an easy switch in early 2024.
Replies to "@brianjarvis We chose Firmagon at the time because my PSA was high (nearly 68) and the..."
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@northoftheborder Good choice.
Regarding the testosterone surge (especially with a tumor near your spine), this testosterone spike can be prevented by starting with Bicalutimide (Casodex) a short period of time before starting ADT, which blocks T from attaching to prostate cancer cells, reducing the risk of tumor (testosterone) flare when hormone therapy is started.
Tumor flare does not last long and will go away as the T level continues to drop.
https://www.oncolink.org/cancers/prostate/treatments/tumor-flare-in-prostate-cancer
Also, some these days start with Orgovyx (to prevent testosterone flare), then once testosterone is suppressed switch to one of the others (Lupron, Eligard, etc.).