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To answer a few questions:
During this several year journey genetic etc. testing not done. Will ask the Dr about it.
Was given a three month shot of Lupron before 33 radiation treatments. Hot flashes and tired but the major thing was the mental fog. Wife was ready to move out and I was having trouble remembering where I was at while driving, could not think straight. Told the Dr no on the second shot.
Since no cancer showed on the scan the Dr suggested six weeks of ORGOVYX to see how I am dealing with the side effects. Will add an second ADT if I can handle the side effects. He also mentioned waiting until the PSA was considerably higher so the cancer might be detected with the scan. I didn't want to wait until the PSA reached the 5 to 10 range. We were hoping the scan would show a tumor that could be radiated, clear scan was unexpected.
Still not clear on what treatment is best. Dr Kwon said don't treat if you do not know where the cancer is. I have watched several of his you tube videos but have not seen him discuss treatments if PSA is rising with clear scan.
I made that mistake with prostate bed radiation. Now if cancer does show up there Dr said can not be radiated again.
Thinking about a second option but not sure who to contact. Does anyone have experience with Dr Scholz in LA?
Replies to "To answer a few questions: During this several year journey genetic etc. testing not done. Will..."
I saw Scholz for 14 years starting in 2012 with a very small amount of Gleason 3+4. I was on AS the whole time until treating 4+4 at Mayo in December 2025. He is a good doc. Pricy, as he now uses a membership system, and new patient costs seem rather high. If you can afford him a good option. He mostly tips his hand with his videos. My take is that he is likely one of the few docs that think less adt is better than more adt. With psma scans being the backup plan to find recurrence disease on then zap spot(s) with radiation.
I have been on Firmagon for 4 months. Very little side effects other than expected loss of sex. Doc wanted me to go on Lupron and told him no, stick with what works. It dropped psa from 6 to .3 in one month. Hit the fitness club three times a week. Working for me anyway. Good luck, god bless.
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@tallbob
Orgovyx acts almost identical to Lupron. It will reduce your testosterone, which can cause the same side effects. You won’t have a second ADT since Orgovyx Is ADT. You Might have an ARPI like Zytiga or a lutamide. Darolutamide Is the easiest on the body and does not cause additional brain fog since it doesn’t pass the blood brain barrier it also doesn’t cause additional side effects for almost anybody.
The thing is Orgovyx Will also cause the brain fog, Hot flashes and fatigue. Hopefully, you can handle it better with Orgovyx, The problem is the low testosterone is what causes the problems and both drugs do the same thing. Drop your testosterone low.
Must admit your brain fog is the worst I’ve ever heard. I can’t remember words or names at times, but know how to look them up. Never get lost driving, that’s a tough one to put up with.
Dr. Kwon And Doctor Scholz Both follow the same idea when it comes to treating advanced prostate cancer. They both want to wait until they can see something and then zap it. Since you started off with radiation, that may be one option. Taking the two types of drugs, really is a good option, for many. That can stop the Cancer from growing and spreading.
If you really really want a different opinion, you should see a different doctor than Scholz.