Treatment Advanced Prostate cancer Stage 3C

Orgovyx and Biclutamide can work to keep the cancer from growing with fewer side effects. I do not understand what other injection you are talking about, There are no injections that would normally be added at this point. What did the doctor say would be used? Eventually, you want to get off Biclutamide. Darolutamide Would be a great choice since it has very few side effects, for most people none. It also works better than Biclutamide. I was on Biclutamide For a little over a year, but it didn’t keep my PSA down, it kept rising. Darolutamide Has kept my PSA undetectable for 28 months.

For a Gleason nine, ADT If he can handle it at 83 without serious side effects, And 44 sessions of radiation can allow him to have remission for a long period of time. The fact that he’s having 44 sessions and not under 30 means that there will be less radiation used each time which is beneficial in reducing side effects of radiation.

Be aware of that Orgovyx has a lot of side effects. Actually due to a lack of testosterone. Those include

Hot flashes
Fatigue
Muscle deterioration
Bone weakening
Brain fog
Depression
Weight gain
Joint pain
Difficulty in breathing

Not all of these side effects occur to everyone on the drugs. Most of them are just things you have to be aware of and circumvent. I walk on the track twice a day, 1 mile at least, to help prevent bone weakening, fatigue and muscle deterioration. I also go to the gym three days a week (usually) and spend an hour with all different types of weight exercises. One thing that happens is people get a beer belly from the muscle deterioration, I do a lot of sit-ups to offset that.

Some people get depression but it is not common. It is easily treatable, according to people that have reported it on here and on Online Meetings I have participated in. If he has that problem Come back and ask for help, Or see a psychiatrist about doing something to relieve the depression.

Some people get no hot flashes at all. Others only have a few hot flashes and they are very minor. I had severe hot flashes for the first year on Lupron. As a hot flash was hitting I would feel a lot of fatigue. After a year, my oncologist prescribed a depo-provera shot every three months and it really stopped those hot flashes on Lupron. There are other hormones that can do this, speak to your doctor. If you have this problem, we can give you a list of drugs that can stop it.

While on ADT, you should be taking calcium and vitamin D every day . It really weakens the bones and those two things can make them stronger.

I have never gained any weight while on ADT. I get on the scale every morning and base what I eat on what I weigh. Skip lunch at times. Some people gain a lot of weight. The average is 5 pounds but some gain more and some gain none.

Thanks so much, Jeff. He’s already taking the calcium and D3. I thought the shot was Lupron, but doc didn’t post after visit notes on the hospital portal. This is SO helpful. I’m grateful to you. My own cancer journey had less troublesome side effects, so trying to gather all the info we need to help alleviate them - as well as some informed questions for the doctor.

Hi...Gleason 9 Stage IVB here. My treatment plan is Orgovyx/Nubeqa w/ 20 sessions IMRT. 55Gy total. No mention of other injections or additional treatment at this time. Journey started May 2025. Radiation was Oct 2025. Waiting for updated bone density numbers and 3-month bloodwork will be done next week so we'll see but, so far, so good. Standard list of side effects (hot flashes, joint pain, fatigue, etc.) but none debilitating. I am 12 years younger than your husband. Best wishes.

@mjp0512 Thanks so much for sharing this. Where were you treated?

@mjp0512
Hopefully that treatment you’re on can keep you in remission for a long period of time. I am also on Orgovyx and Nubeqa And it has worked really well for me starting it 14 years after my initial surgery.

Keep us up on how things are going. Always interesting to hear about long-term results with people that have Gleason nine.

@jeffmarc
You can always check my profile. I keep that up to date.

@franciekid
Penn Med with Kimmel consult.

@mjp0512
Problem in doing that is I don’t see your profile unless you post. I almost always check a person’s profile as long as they have written something.