ADT injection: Benefits worth the toll it will take on my body?

I'm 67, dealing with Prostate cancer which has progressed from stage III initially to (textbook) Stage IV metastatic (Lumbar spine) now castration resistant. I started on Eligard (an Agonist), but had too many CV issues (near heart failure, near stroke). I changed to Firmagon (an Antagonist) and have no CV issues further than High Ventricular rate every so often (2-3 seconds at a time about once a month...).

My research and experiences shows that ADT, regardless of the agent, will increase your BP, Blood sugar, bone loss, etc, etc, etc...I chose to continue the belly injections of the Firmagon, because I would rather deal with the "injection-site pain" than run something through my digestive tract (Orgovyx)...My digestive system is working fine...I'd rather keep it that way.

Either way, this disease and it's pattern and subsequent treatment is always a "lesser of evils" or "Benefits vs. Risks. It's a crap shoot no matter how you slice it...The odds are ...for the most part...against you (us)...

My advice is to obviously monitor everything!! BP, BS bone density, weight, energy level, etc...daily! Keep positive, have a support group and keep copious notes!!!

Blessings to all in your endeavor!!

I'm 67, dealing with Prostate cancer which has progressed from stage III initially to (textbook) Stage IV metastatic (Lumbar spine) now castration resistant. I started on Eligard (an Agonist), but had too many CV issues (near heart failure, near stroke). I changed to Firmagon (an Antagonist) and have no CV issues further than High Ventricular rate every so often (2-3 seconds at a time about once a month...).

My research and experiences shows that ADT, regardless of the agent, will increase your BP, Blood sugar, bone loss, etc, etc, etc...I chose to continue the belly injections of the Firmagon, because I would rather deal with the "injection-site pain" than run something through my digestive tract (Orgovyx)...My digestive system is working fine...I'd rather keep it that way.

Either way, this disease and it's pattern and subsequent treatment is always a "lesser of evils" or "Benefits vs. Risks. It's a crap shoot no matter how you slice it...The odds are ...for the most part...against you (us)...

My advice is to obviously monitor everything!! BP, BS bone density, weight, energy level, etc...daily! Keep positive, have a support group and keep copious notes!!!

Blessings to all in your endeavor!!

@deccakid I think the main work clearing a GnRH antagonist is happening in your liver and (to a lesser extent) kidneys. Something like 80% of the drug will eventually be excreted in feces either way, and a little in urine as well.

So I don't think Orgovyx would pose any different risk to your digestive tract (since your liver is already pumping the Firmagon into your lower tract anyway to get rid of it), but also, if you're happy with Firmagon and it's not causing you any acute problems around injection time like swelling or low fever, no reason not to stay with it.

(Obviously, keep discussing with your oncologist.)

@deccakid
You and I have had similar problems.

I had surgery 16 years ago at 62. 3 1/2 years later, it came back and I had radiation. 2 1/2 years later, it came back and I had to go on Lupron. 2 1/2 years after that, I became castrate resistant and went on Zytiga, Which gave me high blood pressure, Caused me to have four Afib Events, The only reason I didn’t have a stroke was because I was put on blood thinners. Spent four days in the hospital with the pulse 175 standing 150 sitting 125 laying down, Blood thinners saved me. End of Zytiga. None of these drugs has raised my blood sugar, A1C 5.4 yesterday, and I never had fatigue problems. ADT didn’t give me high blood pressure had to get on Zytiga for that. There are differences in how these drugs affect each of us.

Switched from Lupron and Zytiga to Orgovyx and Darolutamide 3 years ago.. I’ve been undetectable for the last 29 months. Orgovyx Didn’t cause any stomach problems.. I know well over a dozen people on Orgovyx, none have reported stomach issues.

2.5 years ago, I had a metastasis zapped on my L4, it was wrapped around it and took three SBRT sessions.

I’ve had skipped beats and ventricular problems(PVC’S) for probably six or seven years. Lately I’ve been having them daily, recently, going for long periods with double beats (PVC) and skipped beats. A Blood thinner is my best friend with this.

I have BRCA2 and cutting back on my ARPI raises my PSA immediately. Still here 16 years later, and you would never know I had PC if you met me. I jog a mile on the track twice a day and go to the gym three days a week.

I have been on bone strengtheners for seven years, since I’ve been on ADT for eight. That is a real important thing to do if you have to stay on ADT. Been getting monthly Blood test for eight years as well. Have to keep track of what’s going on like you say.

Just good to know prostate cancer is a chronic disease, not a deadly disease these days. Great drugs.

Keep up the good health.