Share your test results (if you'd like)

@jime51
How did you tolerate the orgovyx?

@mjm8491 I was the poster child for side effects: weight gain (mostly belly fat), hot flashes, ED, loss of libido, killer fatigue, diarrhea, loss of body hair, rise in Triglycerides and blood sugar, drop in red cells...every side effect on the Orgovyx.com website and more. Exercising about 75 minutes weekdays has helped some with fatigue, and I have to correct my eating in order to get the rest of my numbers back in order. Orgovyx did a great job on my cancer, taking the med for 18 months and having PSA <.01 and Testosterone <10 for more than a year. I'm three weeks post treatment and hoping for some recovery by Fall.

13 years ago my prostate was taken out in a surgery today my psa is 0.2 I am 77 years old healthy and sportive. My doctor recommended salvage radiation to the prostate bed. I don’t like it, because my sex life is good and I don’t have any problem with my urine. What are the other alternative?

@tzach
Salvage radiation doesn’t usually affect sex life right away. That can take a few years before it stops working. I didn’t have any problems after salvage radiation, The incontinence didn’t start for six years. It doesn’t happen to everyone.

You need to take a look at your doubling rate, if the PSA is rising quickly, you need to treat it. Some people can stay at .2 for a year or two maybe move up to .3. And those cases you can hold off the radiation.

Here’s the recommendations from the American Society of clinical oncology for what to do after the PSA rises following a prostatectomy.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.

0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.

0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/
I had salvage radiation 3 1/2 years after my prostatectomy when my PSA hit .2. They gave me an ADT shot two months before I had the radiation. If you get an ADT shot that will end your interest in having sex, Or at least diminished greatly. That does increase the chance that you will benefit from the radiation.

Some doctors believe that you can just hold off and keep doing PSMA Pet scans and wait until a metastasis shows up and zap it. That may or may not work for you. If someone gets a lot of metastasis that can become quite painful and be difficult to treat.

Here's mine.

Had labs on Thursday, last ones were January.

PSA came in at .04 vice .03. T was 450+. Free T 79 so, in a good range for a 70 year old.

I see my oncologist on the 13th, could just be "noise," could be a sign that after 27 months after my last treatment ended, "it's back..." Given my clinical history, especially doubling and velocity times, if it's back, we'll know sooner than later.

No panic though, I'll probably go back to three months, go from there.

It's gone up and down before...

We have criteria in place on imaging, wait until it hits .5-1, image and then decide, if, with what and fur how long with de-intensification criteria.