On Orgovyx and abiraterone: Radiation with or after ADT?

Posted by david1h @david1h, Mar 13 7:29pm

Hi,
I have been diagnosed prostate cancer Gleason Score of 9 High risk.
One Doc wants to start radiation therapy immediately. The other Doc wants to wait 4-5 months to let the hormone therapy work on the cancer cells. I don't know which to go with, anyone have this experience, any opinions?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

hbp | @hbp | Mar 13 8:18pm

I am also G9, CR PC, My surgeon wanted me on ADT and Erleada for 6 months before surgery as his experience was that making the cancer smaller resulted in a more successful surgery. My PSA went down very quickly with these meds. This could be the same thinking when taking radiation. Good Luck to you!!

ecurb | @ecurb | Mar 14 9:18am

I have agent orange Prostate cancer stage 4, gleason scores 9-10. I got 28 RT treatments immediately following the biopsys. Also started ADT....arbiterone at the same time 250 mg with 5mg prednisone.....PSA is now below 0.01. Was told the ADT DRUG is used because it metasticized to two Pelvic lymph nodes.....this happened last year in Feb 2023. I just take the ADT drug daily and get the butt shot every three months to keep TESTOSTERONE DOWN. Hope this helps ya. Bruce

dwheels8 | @dwheels8 | Mar 14 5:51pm

I haven’t started yet but my doc’s at Mayo have suggested start with 5 months of drug therapy followed by radiation . So I’m going to go with the Mayo recommendation. The Mayo tag line “when it’s time to find answers you know where to go”. Take Care Don

Colleen Young, Connect Director | @colleenyoung | Mar 18 12:10pm

@david1h, I think you might be interested in these related discussions along with the helpful responses you already got.

- Gleason 9: ADT before radiation
https://connect.mayoclinic.org/discussion/adt-before-radiation/

- Questions regarding Radiation treatment after ADT & Prostatectomy
https://connect.mayoclinic.org/discussion/questions-regarding-radiation-treatment-after-adt-prostatectomy/

- Salvage radiation therapy with 6 months Eligard
https://connect.mayoclinic.org/discussion/salvage-radiation-therapy-with-6-months-eligard/

david1h | @david1h | Mar 18 2:08pm

In reply to @colleenyoung "@david1h, I think you might be interested in these related discussions along with the helpful responses..." + (show)

Thank you so much, those pages really helped me!

gently | @gently | Mar 20 6:25pm

Radiation is whole prostate, so reducing the size of the tumor isn't as helpful as with surgery. ADT is said to work synergistically with radiation making the tumor cells more susceptible to the radiation. But I wonder if it doesn't make all your cells more susceptible to radiation damage.
If you decide on ADT, I'd suggest orgovyx instead of lupron and ask your doctor for 5mg Cialis daily because it increases the vascularization of collateral tissue and may save you some side effects.
What is your own inclination? And which doctor do you have more faith in? Two month is said to be the "sweet spot" (ridiculous term in this regard). with ADT. Maybe you could compromise with two months instead of five.