Starting Orgovyx - how long for side effects to occur?

@firespooks Our Blue Shield insurance covers the Orgovyx. We have a very good plan unfortunately we can barely afford it now due to the loss of ACA assistance.

@jeffmarc
Thank you

What about hormone therapy causing heart issues or diabetes. From what I've read it is very common. I'm hesitant to add hormone to radiation because I'm pre-diabetic & have CAD. If I do hormones it will probably push me into type 2 diabetes and maybe heart attack or stroke. Is there any safe hormones with less issues. Think I could deal with the regular hormone side effects for six months but don't want it to kill me!

@copyman
I’ve been on ADT for eight years. I’ve been able to regulate my blood sugar by eating properly. That may be things that you’re eating that need to be changed, The drug doesn’t have to cause your Blood sugar to rise if you eat more carefully.

Have you tried changing your diet in the past so that your Prediabetic diagnosis can be managed. Maybe 15 years ago, they told me I was pre-diabetic, I made just a few changes to my diet and I’ve never been considered that again. In my case, I stopped eating ice cream with chocolate topping every day, Also stopped eating things with high carbs. Made a big difference.

Have you been able to speak to a dietitian about changes that could help manage your blood sugar level? Most insurance companies will pay for that if you have being diagnosed prediabetic. I went to one years ago and though I don’t keep to exactly what they recommended I followed enough of their recommendations to keep my blood sugar low.

I’ve been able to keep my A1c below 5.6 for years, It did go to 5.8 a couple of times a few years ago but I just changed my diet and now it is below 5.6. Eating a lot of sweets is going to definitely affect your blood sugar. Watching how many carbs you eat can help manage the blood sugar level. I do eat a couple of cookies or a small piece of cake every single day. I try not to eat any more sweets than that, though occasionally I will eat one more cookie or a piece of candy. Binging is just not possible if you want to keep your blood sugar at normal levels.

Thanks Jeff, Good advice and yes I've changed my diet. If not i would of had diabetes by now. It's been many years I've been in the pre-diabetic state. It runs in my family.

What is your opinion about hormones and the affect it could have on the heart? Someone with Coronary Artery Disease. Some studies I've read showed hormone therapy was very dangerous for someone with heart conditions?

@copyman
Just ADT is not too hard on the heart for most people. I’m not a cardiologist so I can’t say how it would Affect you. I know people that have heart issues that have been on ADT. When I was having surgery a few months ago, they did not have me stop Orgovyx, Wanted me to stop Nubeqa But my oncologist told them that was not necessary. Because I’ve had multiple Afib Events they were cautious, but ADT didn’t seem to be a factor.

You really need to speak to the doctor about that though, I don’t know the extent of your CAD And even if I did, I would not feel competent to make a recommendation.

Now, if they were to ask you to go on Zytiga, I would say be very cautious, It is hard on the heart.

@copyman Was prediabetic for 5+ years. Then my A1c went up to 8 and went on Mounjaro a month before my PC diagnosis and start of Orgovyx. Lost 15% of my weight, lowered fat percentage, and decreased A1c to 5.4 from Mounjaro. On Orgovyx for 7 months. Now off for 3 months. Libido loss and 50% testes shrink were my only side effects. Exercise and calcium to keep muscle and bone (required for both ADT & GLP1). Took about 7 weeks for libido/ testosterone to return. Some growth observed in testes so not all loss was permanent. So if ADT increases your glucose levels it can be easily treated (a lot easier than the PC).

@jeffmarc Yes I have a consult with my cardio doc, RO, MO. Looking at RO options for 4+3 localized to prostate at 2 different centers of excellence (2nd opinions, etc). PSMA, MRI, TP Biopsy all clear of spread beyond prostate. Biopsy 14 cores all benign except 2 cores showing 55% of pattern 7 in transition zone. Grade group 3.

My case is different because I was simultaneously on Abiraterone with the Orgovyx. So I don’t know which, but I had hot flashes starting the end of week 2. I completed the 6 mos intensive treatment with radiation in the middle, January 30. Flashes continued until (I hope) about two days ago. But they were becoming less noticeable.

My understanding based on the continuous volley of questions I fired in a friendly, curious way to the NP, nurses, Docs and staff is that symptoms track to your Testosterone level. When it gets toward zero, your metabolic functions are messed up. Sounds like yo are not there yet. Like others who commented here, exercise is critical to surviving better. Also what you eat, I found myself more sensitive to Carbs and had to watch that.

Without its Testosterone, the body says “what the heck, where is my Testosterone, you’re screwing with my metabolism and hormones, dude.” What I noticed were the flashes, fatigue, intermittent cognitive slowness, and of course, the obvious: Doctors refer to ADT sometimes as “chemical castration,” and I wondered whether my attitude, presence and interests in the opposite sex would change. They absolutely did not. I was and am in recovery, still totally Male in my thoughts and interests. But ability to do anything about it? Zip. Nada. Zero. Limp city. I may write about it at some point. Along the way since I had to have the intensive and definitive radiation for high risk, I got gold pellets placed around the offending gland in a procedure that required, among other things, for me to be in stirrups. LOL. That and the essentially menopause-like effects, including some emotional volatility which for me was being short tempered. It all gained me terrific insight to the opposite sex. I put a box fan near the bed pointed at me on low, because the flashes mostly bothered me at night. Now in recovery mode, (they tell you it takes a couple months or so) some of the short tempered-ness and stuff is on replay. But whatever.

But the capper was the stirrup experience, feet up and wide, buck naked below the waist, a couple of pretty nurses and a tech down there, a higher level tech at my side chatting with me about music preferences. How did I, as an older man who grew up working as a farm hand, who had a family of kids and now grandkids, end up in stirrups with those helpful onlookers? It is a comedy. Having got through it, I learned a LOT.

Bottom line, I believe it tracks to Testosterone level and every man is different both side effects as well as how long things take. It’s very humorous if you let yourself look at it, and a fascinating, occasionally intense, educational experience. Hang in there.

@steveduke
I had terrible hot flashes on Lupron. For a year, I would have at least seven or eight hot flashes a day where the sweat would pour down over my eyes my chest would get wet. At night, the sheet under me would get wet, No fun to say the least. I found that drinking a pint of ice cold water would help a little bit. Had a fan everywhere for when the hot flash came on.

Then my oncologist recommended a depo-provera shot, A woman’s birth control shot. It stopped my hot flashes, almost completely. Every three months for a couple years, I got one of them. Then I went on Zytiga and back came the hot flashes. I guess this probably sounds familiar to you. I ended up beta testing an Embrlabs Wave 1 device, I am still using the Wave 2 today.. It stopped the nightly hot sweats. It helped a little with the hot flashes during the day. Definitely an improvement.

Same as you, the male thoughts are there when I see an attractive woman, But there’s no ability to do anything.

I’ve been on ADT for eight years now And fortunately, I’ve had no fatigue. As you say, everyone is different there are so many different side effects that you get to pick and choose from without having a real choice , you get what you get.