The Orgovyx vice surgery, radiation or chemotherapy is mono vice doublet or triplet therapy. Mono therapy is no longer the standard of care, the other two are when you read through the NCCN guidelines.

The CV side affects you describe are why I have a cardiologist on my team. In December 2021 I developed Afib, well, actually a few months earlier. Had to do a cardio conversion when it wouldn't stop, we tried different medications, none of which brought it under control, breakthrough incidents while riding my bike...finally in September 22 had the cardio ablation done, problem solved.

You don't say if you exercise, it can mitigate the side affects of ADT. I exercise pretty much daily, ride my bike, swim, lift weights, pickleball, vacations are generally active ones.

Our treatment decisions are personal, based on our preferences and tolerances, quality versus quantity of life. Mine is an aggressive cancer, I lean towards quantity while managing and mitigating quality. I've looked behind "Door #3, death by PCa," no thank you.

ADT by itself does not "kill" or "cure" prostate cancer. Other treatments, radiation, chemotherapy...do. You can live a long life on ADT, then again, you may become resistant though more and more treatment options exist today for that, more are in the medial research pipeline. It may be possible, expect for the unlucky 27K or so each year who die of PCa, to live with PCa as a chronic disease and die of something else, thinks diseases such as AIDS, Diabetes (a good friend of mine died several years ago, he was diagnosed with diabetes in his early 20s, lived 40+ years with it before succumbing to its affects on his system.

The fact that your PSA went from undetectable to 3.0 in such a short time may be a troubling clinical data point, PSADT, indicting a very aggressive PCa.

So, you ask, "sound like a plan"...my answer, yes. It may not be your best plan given what you describe. I certainly was not thrilled about triplet therapy but the clinical data supported my decision and brought 4-1/2 years off treatment. This go around, I initially discussed SBRT and six months on Orgovyx but my medical team showed me the data that pointed towards 12 months, I agreed. Even on triplet therapy, I went skiing in Colorado, exercised most days, did the Bataan March with my sister in White Sands, NM, rode the Garmon Unbound 50 with my daughter...

In January 2024 it will be 10 years since my diagnosis. The words of my urologist reviewing the TRUS biopsy with me still ring in my ears..."Kevin, that's a pretty aggressive prostate cancer...!"

Kevin