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What's your experience with Orgovyx (relugolix)?
Prostate Cancer | Last Active: 5 days ago | Replies (135)Comment receiving replies
Your urologist may be right...you don't say what your PSA results are so difficult to provide feedback. The one cancer doctor you describe may be simply following traditional treatment thinking, PSA is now rising after being undetectable, initiate systemic therapy...ADT.
More mainstream clinical practice is to image with newer scans such as Plarify, PSMA -68, Aximun, which are more sensitive than the C11 Choline. These scans can locate the site(s) of recurrence at PS below .5 though .5-1.0 is more of the "sweet spot."
The question you may want to ask yourself, will imaging inform the treatment decision...if yes, then do it.
What newer imaging can do is inform the treatment decision, particularly for radiation. As you can see from my clinical history in the attached chart, we did a Plarify scan when PSA rose to .7. It located the recurrence, a single PLN. We treated that with 5 SBRT and added six months of ADT to clean up the micro-metastatic PCa. Without the imaging, the radiologist has nothing to "shoot" for.
Also, do a literature search for doublet or triplet therapy, in my experience, suggesting mono therapy is not mainstream thinking.
Kevin
Replies to "Your urologist may be right...you don't say what your PSA results are so difficult to provide..."
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Well said. In my case (intermediate, unfavorable, localized), I talked to experts across the county and decided on treatment at Mayo Clinic because I found an RO who is leaning into the science. I ended up with all of the testing noted followed by SBRT. He's using all previous testing plus my risk profile on the Decipher test to determine if he'll recommend ADT (relugolix in my case), and if so, for how long. Personally, I've never liked the notion of "one size fits all" and "that's the way we've always done it..." I realize that each person's journey is unique, but for me, research to gain understanding and insight and finding a treatment team you are totally comfortable with is key.