Sorry to hear...the decision on treatment is complex and involves a wide variety of factors, some clinical, some personal.

I am a study of one...I and my doctors know that as a high risk PCa (see my clinical history) that I have peaked behind the door of death by PCa, no thank you. So, this is kind of my guidance to my medical team - “ it is important to remember that not dying from prostate cancer is a good thing, however as long as treatment is not the cause of mortality…!”

I did develop AFib after an 18 month stint on Lupron. My cardiologist did not want to see any connection with the ADT, rather, he attributed it to my "moderate" drinking. I threw the BS penalty flag when he said I had to stop. Like your father, active, biking, playing basketball, hiking and skiing in the mountains, swimming, lifting weights...We had to do a cardio conversion, tried various medications, finally, did an ablation. Problem solved.

This go around, the 4th, I am on Orgovyx for six months in conjunction with SBRT to the single PLN identified in the Plarify scan. SES, hot flashes, fatigue, muscle and joint stiffness, albeit mild, usual genitalia shrinkage. I see my medical team, oncologist, radiologist, primary care and cardiologist every three months, no CV issues. Plan is 6-12 months, stop. As you can see from my clinical history, Orgovyx has done its job, T from 608 to undetectable. Hasn't changed my life in terms of playing basketball, biking...did a 50 mile gravel ride with my sister recently.

I would change nothing about my clinical treatment history, aggressive PCa requires aggressive treatment. Well, when I did SRT in March 2016 I wanted to add six months of ADT and extend the treatment field to the entire PLN system based on data emerging from clinical trials and what Mayo had on where recurrence was with BCR after prostate surgery. My medical team dismissed it, saying no long term data. When my PSA continued to climb after SRT, my radiologist looked at me and said, well, you were right...Since that momentous failure, I have made the decision on treatment and it has never been the "standard of care" which is population based and generally historical data driven.

I do believe that when going on treatment, one needs a medical team - urologist, radiologist, oncologist, primary care...and a cardiologist is part of that team given the SE profile of these drugs.

Kevin