Is an ADT Treatment PSA Drop From 25 to 0.63 in 2.5 months Fast?

Though it can take a few months, optimally your PSA should be nearly undetectable and your testosterone levels should be below 50 ng/dL (preferably below 20 ng/dL). (At 2.5 months, my PSA was at < 0.008 ng/mL - and testosterone was in the low double-digits.)

@thanks4sharing Are you on Orgovyx or a different ADT? I think your PSA drop is comparable to mine (not yet undetectable, when it should preferably be).

(I was on Orgovyx last spring, and my PSA dropped from 10.05 to 0.36 in three and a half months, to 0.22 after another three months. I didn't reach the "undetectable" level, but my oncologist advised that six months ADT was good enough (for me). My third PSA test post-SBRT was this week; I will be discussing with my oncologist if I need PSMA PET scan as the rise in my PSA was significant (more than I expected after stopping ADT)).

I went on Nubeqa and Orgovyx in March last year (2025) and my PSA went from 32.30 to 4.1 in 3 weeks and from 4.1 to 0.07 in 4 months.
BTW I've been dealing with the crapola for 31 years. Still above the grass. 😉

Yes, as I understand that makes you an exceptional responder. Fingers crossed that it continues down to undetectable.

Mine dropped to undetectable in two months after beginning ADT.

In my opinion that is very fast. My PSA was 12.1 in July 2023, started ADT took until January 2025 to reach 0.1 then in July 2025 to achieve < 0.1 undetectable. So it took me 2 years to reach undetectable. It took me 6 months to decline to 0.49. So, I would say your outlook is very good.

Yes that is a very good response
From everything I can find or have red or seen that is excellent
Mine went from 175 to 0.5 in a month and a half. I have widespread advanced stage four I am on firmagon and Nubeqa. I haven’t had a update PSA test I am going in February 6 hopefully it is still going down just remember some people will never get to where you’re at much less that soon

ADT shuts down testosterone which feeds prostate cancer growth and can reduce PSA to near zero quickly. The problem is over time the cancer can figure out how to grow around the ADT and PSA begins to rise again. Thankfully there are an array of follow up treatments that can arrest the cancer at least for a while.

Examples include targeted SBRT radiation treatments, chemo regimens and Pluvucto

@capatov The other recent change is the discovery that starting an ARSI at the same time as ADT for metastatic castrate-sensitive prostate cancer (instead of waiting until the ADT stops working) significantly delays or sometimes even prevents castrate resistance.

The TITAN study demonstrated that (dramatically) for ADT+Apalutamide — to the point that they had to unblind the study halfway through and give the placebo group the opportunity to start on Apalutamide as well.

LATITUDE showed a similar result for ADT+Abiraterone, and there have been successful studies for Enzalutamide and Darolutamide as well.

In the past few years, this new "doublet therapy" has rewritten the book on prostate cancer becoming castrate-resistant in "a couple of years" (as they used to tell us).

Interesting…I was unaware of this development. Thanks for sharing