Urologist said I could stop Orgovyx. Your thoughts?

I'll be doing tests for PSA every 3 or 6 months after going off Orgovyx.

Took Orgovyx for almost 20 months, Gleason 9, IMRT 28 sessions. Latest blood test results this week, 4 weeks after going off Orgovyx= PSA less than 0.04, testosterone increased from less than 1 to 55.

@johnny8924

Good morning - just wondering your decision to stop adt. My situation - gleason 8 with SV invasion., I've been on orgavux for 14months - four psa tests in last 12months all undetectable - also 28sesions photon radiation. I would like to stop the adt have read numerous articles of minimal advantages over taking adt over 1yr. I'm 71 .

@jeffmarc Hi Jeff, Gleason 9. Prostate removal and salvage radiation in 2020. Slight PSA steady rise to .053. PSMA detected some cancer hot spots. Current PSA 0.014 (essentially zero - the lowest reading lab test can show). I’m approaching a show-down with my medical oncologist after one year on Orgovyx + Nubeqa. What would be my best argument to my doctor to take a drug holiday after one year instead of going the two years he seems to be stuck on. Any supportive studies in addition to Libertas? Thanks.

ADT brings its own systemic harm. An oncologist I consulted at MSK warned me about it.
Low testosterone leads to loss of calcium from the bones. The calcium ends up clogging the blood vessels. Calcification is hard to reverse. If the urologist says you can get off this medicine, before deciding to continue it, consult a cardio-vascular expert and also an oncologist.

@lsk1000
After one year with such a low PSA, it may make sense, But the longer-term of ADT is recommended for a reason.

Rick Davis talked about this type of decision in the recent ancan.org Weekly advanced prostate cancer meeting. Rick, who started ancan.org, talked about his friend who had a Gleason nine and decided that after a year of ADT he would stop because it Interfered with his running a big company. He encouraged the guy not to do it, But he did it anyway. Within a few years, he had to have chemo, it had spread considerably. He died not long after. Just something to think about. Weigh how aggressive your case is, what aggressive things were found. Did you get a decipher test to find out your likelihood of a reoccurrence?.

Lots of things to think about for a Gleason nine.

@jeffmarc Thanks Jeff.

Looks like I might have to tolerate the fatigue a little longer, which btw is making me an efficiency expert finding ways to do things around the house with as little energy expenditure as possible, and accept looking more like the Pillsbury Doughboy for a little longer,

@lsk1000
The one thing that really helps with fatigue from ADT is exercise. Getting out and walking or running going to the gym or doing weightlifting at home, those things relieved a lot of the fatigue. It seems counterproductive, but it actually works for almost everyone.

A metanalysis of 13 high quality studies with 10,000 patients: JAMA Oncology JAN 2026 : Definitive Radiotherapy and optimal ADT for Prostate gland confined disease. PET CT Scan Neg for metastasis
"... reduced estimated benefits being observed beyond androgen-deprivation therapy durations of 9 to 12 months. A near-linear increase in risk of mortality from causes other than prostate cancer was observed with longer deprivation,
0, 6, 9, 12 months of ADT
Intermediate: One risk factor, Two risk factors, high risk, and very high risk factors

uration of androgen-deprivation therapy (HR for 28 vs 0 months = 1.28, 95% CI = 1.09–1.50, P = .002). Compared with 36 months of treatment, risk of other-cause mortality was lower with 3 months (HR = 0.60, 95% CI = 0.45–0.80) and 6 months (HR = 0.77, 95% CI = 0.66–0.89).

The optimal androgen-deprivation therapy durations based on 10-year risk of distant metastasis were 0, 6, and 12 months and “undefined” for patients with one NCCN intermediate-risk factor, two or more NCCN intermediate-risk factors, NCCN high-risk disease, and NCCN very high-risk disease, respectively.