Recurrent prostate cancer and Eligard.

I'm sorry to hear your husband's news.

The main chronic side effects of testosterone deprivation are the same no matter how it's happening, but I have found Orgovyx pills easier to tolerate than Firmagon injections, because I get a microdose every day instead of one megadose a month (in the case of Firmagon).

Erleada may or may not add additional side-effects (I've been tolerating it fine for almost 4 years, but everyone's different).

There are many 1st generation hormone therapy (i.e., ADT) alternatives to Eligard - Lupron, Prostap, Camcevi, Lucrin, Zoladex, Trelstar, Pamorelin, and Decapeptyl - but, they all have similar side-effects due to the suppression of testosterone. Firmagon (an injection) and Orgovyx (pills) also suppress testosterone and have similar side-effects (though some say they’re more tolerable than the other ADTs).

There are also other 2nd generation hormone therapy (i.e., ARPI) alternatives to Erleada (apalutimide) - Zytiga, Xtandi, and Nubeqa.

Doublet therapy (ADT + ARPI) appears to be what’s more effectively done these days.

Discuss with your doctor which combination would be most effective.

You really are in a position where there are no great choices if you want to live the longest ADT or equivalent is necessary. This is where the level of prostate cancer development has us, at this point in history.

The thing is reducing testosterone is essential to stop the cancer from growing and spreading.

You can go with Orgovyx as recommended by @northoftheborder, no need to go in for a shot. It’s a little easier to start with, At least it was for me for the first few months And others have reported the same.

The patch trial Completed in England recently and showed that estradiol worked just the same as ADT, but had many fewer side effects. It’s easier on your cardiovascular system, On your bones (osteoporosis), causes fewer hot flashes and less brain fog. If your doctor has not heard of the patch trial, there is a lot of information about it so come back and we can help you.

Erleada (apalutamide) also works to get the PSA down, If you have side effects from this drug, specifically, switching to Darolutamide Could relieve those side effects. You could have less brain fog with Darolutamide Because it doesn’t pass the blood brain barrier..

You were getting the standard of care that’s available today. Getting a second opinion, can’t hurt, It should be from a center of excellence or after speaking to a Genito Urinary Oncologist. The problem is that what they recommend is what is considered the standard of care so there’s not much somebody else can do.

I’ve been living with PC for 15 years. I’ve had surgery and it came back and radiation and it came back and two more reoccurrences, but I’m still Here because I’ve followed the guidelines for what drugs I need.

Since your husband has problems with ADT drugs, he should post on here or you can post on here about what those problems are. Many of the people on here have experienced those problems and may have ways around them.