Anyone considered bilateral orchiectomy: Why or why not?

Posted by rxharleydude @rxharleydude, Sep 21, 2022

Been treated for metastatic prostate cancer for the past 11 years. 82 yo & had a total prostatectomy. Have been successfully treated with Lupron for the past 10 yrs and Zytiga added about a year ago. Considering a bilateral orchiectomy to be able to hopefully get off the Lupron/Ellegard (very painful option compared to Lupron)
Has anyone considered this option & if not, why?

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@sbd
It is not mandatory to have an ARSI but if your PSA starts rising, it is the main solution right now for you to keep your PSA down.

Many people who have prostate cancer and are on ADT, which keeps their testosterone almost undetectable, still become castrate resistant And require an ARSI or their PSA will start rising. That happened to me, First, I went on Zytiga Which kept my PSA down, but not undetectable for 2 1/2 years. I moved on to Nubeqa Which is kept me undetectable for two years. I know many people that have moderate testosterone levels and are on Nubeqa Alone, and it keeps their PSA undetectable.

An ARSI like Nubeqa Has very few side effects and doesn’t pass the blood brain barrier so it doesn’t cause brain fog and keeps the PSA down quite reliably.

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@jeffmarc
Thank you Jeff, that's helpful. I was also trying to find a post where you had commented, that adding ARSI or APRI at the initial treatment (ADT + RT), helps in better control or probably in OS. I could be wrong...

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Profile picture for sbd @sbd

@jeffmarc
Thank you Jeff, that's helpful. I was also trying to find a post where you had commented, that adding ARSI or APRI at the initial treatment (ADT + RT), helps in better control or probably in OS. I could be wrong...

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@sbd
Adding an ARSI (ARPI is the same thing) when you are on ADT has been shown to greatly extend the amount of time it takes to become castrate resistant.

Median survival after becoming castrate resistant is two years. Happened to me six years ago.

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