@tjs911
16 years ago I had surgery. 3 1/2 years later my PSA started rising so when it hit .2 I was put on Lupron for six months and two months later had salvage radiation. 2 1/2 years later, my PSA started rising again And I was put on Lupron. 2 1/2 years later, I became castrate resistant and was put on casodex for over a year, When my PSA hit 1, I was put on Zytiga With prednisone. In the 2 1/2 years, I was on it my PSA was only undetectable for one month.. It did keep it below .5 most of the time. It caused me to have four afib events, severe hot flashes and high blood pressure which I still have today, and I have to take three different drugs twice a day for it.

I do know people that had many years of Zytiga With success. I was working with one guy who had extreme fatigue from it, Helped by increasing prednisone from 5 mg to 10mg. But it never went away completely and he finally got off of it.

For a long time Zytiga Was recommended over the lutamides for first use with ADT. It did work well for many, but some had serious issues. We Now have Darolutamide Which causes no side effects for most people, So it is being used more and more instead of a Zytiga. Apalutamide is used for those that are not metastatic and castrate sensitive, unfortunately, Daro has not been approved for them yet.