ADT & Radiation, next part of the adventure!

I had almost exactly what your doctor is recommending. 3 1/2 years after my surgery, but PSA started rising and when it hit .2 they gave me a 6 Month Lupron shot and two months later I had eight weeks of salvage radiation.

A recent study showed that ADT actually worked better if given at the time of radiation rather than two months before. The benefit of giving it two months before is that it reduces the size of the tumor and also the size of the prostate making the radiation more effective, say doctors.. The trial that they did showed it really didn’t make it any better.

More information

Evidence suggests that for prostate cancer, adding Androgen Deprivation Therapy (ADT) concurrently (during) or immediately after (adjuvant) salvage radiation therapy offers superior benefits compared to starting it long before, as it specifically acts to sensitize cells or clean up microscopic disease. Concomitant use with radiation is generally favored over early pre-treatment to maximize control and minimize toxicity, especially for patients with PSA levels ≤0.6 ng/mL where ADT might provide little benefit.
National Institutes of Health (NIH) | (.gov)

My husband is on the same boat. He has Gleason 8 and stage 3Tb with recurrence in one lymph node (right external iliac) shown on PSMA scan. He has pre-existing hyper tension. He started Orgovyx today because either Orgovyx is safer for his condition. He'll be on it for at least one year. So far, he experienced mild hot flash but quite fatigue.

Orgovyx since 6/2025...relatively normal side effects of testosterone dropping to single digits. Fatigue, joint pain (mild), weight gain (about 10 lbs.), muscle loss, etc. Very important to stay active during this period. Even on days when your body doesn't feel like it. Doesn't have to be much. I walk 2-3 miles and train with resistance bands. Skipping this produces a noticeable crash in how I feel.

Radiation 20 sessions 55 Gy total...minimal side effects from radiation for me. It did shut down what little urine flow I had but that was a problem going in, and when I need a bathroom for a bowel movement, I need it now, but no continence issues. Some pretty strong fatigue during the last week or so but that cleared up quickly after it was over. During treatment the full bladder, empty bowel thing is important. Practice that for a week or 2 going in. Good luck!

Hey Chipe, the best I can tell you is that it is like a short term job - it takes work if you want it to be successful with less SE’s.
I used the 10 weeks before radiation to fine tune my diet, as I eat tons of fermentable fiber (beans, corn, broccoli, etc) which is forbidden during radiation. My whole system shut down and I had to find ‘no gas’ fiber substitutes to stay regular…it really drove me nuts but you may not have this problem so just consider it a heads up if you do.
The second part of the job is exercise, exercise and more exercise; you have to breathe hard and sweat during whatever aerobics you choose and you MUST lift weights to maintain muscle tone.
You don’t have to kill yourself with them, but you want to use a comfortable weight to load the muscles and not stress them. There are plenty of simple moves and you can use dumbbells, barbells or a machine, doesn’t matter.
The important thing is that you remember that this is a job and job performance counts! You will get out what you put in and it will be over before you know it. Then, you can retire🤞Best of Luck!
Phil

@heavyphil Your description of your diet before RT, your nutritional prep work, and your exercise routine during RT matches my own to a T. Exercising has retained my muscle mass, kept me from sleeping away my life during treatment, and leaves me in a good mood and happy about resolving my health issues rather than stressing over it.

I go to the gym about twice a week to push my muscles to exhaustion; in between I do a combination of dumbell strength training, yoga, pilates, and walking/hiking 3-5 miles multiple days a week. Even been skiing a few times during RT for a couple of hours each with my wife. Empowering for me and makes her happy too.

I'm on Orgovyx and have 5 more rad treatments to go. I'm still working on dealing with sleep disruptive hot flashes, but I see it as another challenge to overcome as a warrior, not as a slave to the disease.
Gotta ride the beast, not let it drag you around. After 6 weeks of ADT and weeks of RT, my muscle mass has increased slightly, my fat percentage is down slightly, and I'm down 15 pounds (mostly from cutting alcohol...I do like my craft beer).

Yes, this does sound like a job, but one that keeps you feeling connected to life rather than sleeping through it.

I did 3 months of Lupron and 3 months of Orgovyx. Orgovyx was easier as I developed anemia on Lupron. My bloodwork was back to normal after my course of Orgovyx and started feeling better 3 weeks after completion. 2 grade one hot flashes so was a fortunate one. For me radiation totally sucked. I suspect the techs hit me with less than a full bladder a few times causing severe bladder inflammation and proctitis. Many of the guys here have breezed through all of this.

@chippydoo I can definitely see that happening; techs are only human and some of them are more human in the worst way.
For some, staying on schedule is more important than the person they’re treating.

@heavyphil Yep, that $5K per 15 minute slot.

I’ve been on orgovyx for over a year and completed 8 weeks of daily radiation last July. 6 more months of Orgovyx to go. My side effects have been worse than many. I still have multiple daily hot flashes, am up 20 pounds, and the stomach problems have been continuous. I’ve found pepto bismal and kombucha help substantially, and am eating roughly 50% of the amount I ate pre treatment. There is continual fatigue, but I stay the course and am going to come out clean. Luckily, my wonderful partner is beside me every step of the way. I don’t complain, but she knows when things are bad. Just keep going is my mantra….

@dogrocketp do you exercise at all?