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Adding a second medicine question

Posted by pjsatz @pjsatz, 2 days ago

I am told by doctors they would like to add second medicine to Orgovyx which I have been doing ok on for about 2 1/2 months. They say I could stay on Orgovyx only but there is possible benefit to adding a second one. I did not do well on abiraterone and prednisone, had bad headaches. If approved I could try Yonsa with a different type of steroid. I could try one of the androgen receptor inhibitors. Is it worth taking an androgen receptor blocker when my testosterone is around 10 ng/d and psa has dropped a lot?

A second drug could possibly help with delaying disease resistance. But it can also encourage some types of resistance. I don’t know that there is a definite answer here but just looking for any ideas or experiences in a case like this.

Thanks,

Phil

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lsk1000 | @lsk1000 | 12 hours ago
In reply to @pjsatz "Thank you, seems like one of the best combinations in many cases." + (show)
@pjsatz

Thank you, seems like one of the best combinations in many cases.

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Thank you. Makes my spirits soar to hear that.

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ga73ds | @ga73ds | 10 hours ago
In reply to @jeffmarc "After all this time, if your PSA has remained < .01 For over a year, stopping..." + (show)
@jeffmarc

After all this time, if your PSA has remained < .01 For over a year, stopping ADT really makes sense.

You can get blood test every month for three months(or longer) to see if the PSA starts rising, Then every three months if still low and eventually every six months.. Close to 70% of people with PC are cured or at least go into long-term remission.

I know a lot of doctors would recommend that, you could get another opinion.

I attend weekly advanced prostate cancer meetings with Ancan.org. We had somebody come in to a meeting recently who had his PSA start to rise 30 years after he had surgery, He was a Gleeson nine also. We actually get a lot of people in who are Gleason nine and their PSA starts to rise after many years off drugs.

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"Close to 70% of people with PC are cured or at least go into long-term remission." I hope and pray you are correct. With Stage 4a, Gleason 9, and Decipher .99 at diagnosis its been hard for me to be positive. I've had removal + radiation + ADT (Orgovyx 29 months). Although my PSA has been < 0.01 for 25 months now post radiation, It's scary to risk coming off ADT. But, someone else on here said that maybe the "PSA trajectory" has been changed. I know I probably need to come off ADT to see what will happen, but that's scary.

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boniyabes | @boniyabes | 9 hours ago
In reply to @northoftheborder "The -lutamides (Apalutamide, Enzalutamide, and Darolutamide) are newer than Abiraterone and don't require a steroid, if..." + (show)
@northoftheborder

The -lutamides (Apalutamide, Enzalutamide, and Darolutamide) are newer than Abiraterone and don't require a steroid, if you want to ask your oncologist about them. I've been on ADT + Apalutamide for nearly 4 years, and the combination has been highly effective for me (your mileage may vary).

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Is the ADT you are now taking is Orgovyx?

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1 reply
northoftheborder | @northoftheborder | 2 hours ago
In reply to @boniyabes "Is the ADT you are now taking is Orgovyx?" + (show)
@boniyabes

Is the ADT you are now taking is Orgovyx?

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Yes. Firmagon for the first 2½ years, then Orgovyx (basically Firmagon in pill form) for the past 14 months.

Orgovyx has been a real game changer compared to getting the injections — my body's much happier with a daily microdose than it was being whacked with a monthly megadose.

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