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Urologist said I could stop Orgovyx. Your thoughts?

Posted by johnny8924 @johnny8924, Mar 25 7:56pm

Age 73, in very good health. Diagnosed with Gleason 9, August 2024. Been taking Orgovyx since then, Not quite 20 months. Completed 28 sessions of IMRT April 2025. Latest lab results a few weeks ago: PSA < .04, testosterone < 1. My urologist said I could go off Orgovyx when my medication runs out in 15 days. I’m somewhat hesitant to do so because who knows how my PSA and testosterone levels will be affected. Thanks for any feedback, thoughts, etc.

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deccakid | @deccakid | 2 days ago

Mr. Marchi,
Thanks for your reply. I've discussed many "next-step" treatments and, of course, discussed what you mentioned. Frst, my apologies for being blunt, but please do not tell me what I "should be on". No body's cancer type, progression, body chemistry is the same nor reacts to any given treatment the same.

Metastatic...???...hmmm...'spreads to bone?...to lymph nodes?...to the Prostate itself or other organ tissue???
Very much part of an important diagnosis and treatment options...And this, from the NIH:
"No, Androgen Receptor Pathway Inhibitor (ARPI) treatment—such as abiraterone, enzalutamide, apalutamide, or darolutamide—does not guarantee a lifelong absence of castration resistance. While ARPIs significantly delay progression and extend survival in metastatic castration-sensitive prostate cancer (mCSPC), many patients eventually develop resistance..."

It has long been debated why in some males the body becomes resistant to ADT, but statistically, most will succumb...If you are one of the lucky few that this does not happen, then Bless you!!!

Please try not to speak in such definitive terms...But I hope you continue to keep this pesky disease at bay.
Blessings

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jeff Marchi | @jeffmarc | 2 days ago
In reply to @deccakid "Mr. Marchi, Thanks for your reply. I've discussed many "next-step" treatments and, of course, discussed what..." + (show)
Profile picture for deccakid @deccakid

Mr. Marchi,
Thanks for your reply. I've discussed many "next-step" treatments and, of course, discussed what you mentioned. Frst, my apologies for being blunt, but please do not tell me what I "should be on". No body's cancer type, progression, body chemistry is the same nor reacts to any given treatment the same.

Metastatic...???...hmmm...'spreads to bone?...to lymph nodes?...to the Prostate itself or other organ tissue???
Very much part of an important diagnosis and treatment options...And this, from the NIH:
"No, Androgen Receptor Pathway Inhibitor (ARPI) treatment—such as abiraterone, enzalutamide, apalutamide, or darolutamide—does not guarantee a lifelong absence of castration resistance. While ARPIs significantly delay progression and extend survival in metastatic castration-sensitive prostate cancer (mCSPC), many patients eventually develop resistance..."

It has long been debated why in some males the body becomes resistant to ADT, but statistically, most will succumb...If you are one of the lucky few that this does not happen, then Bless you!!!

Please try not to speak in such definitive terms...But I hope you continue to keep this pesky disease at bay.
Blessings

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@deccakid
You mentioned having to stop and restart ADT because PSA keeps coming back. That’s no fun.

An ARPI like Darolutamide Would allow you to stay away from ADT so you don’t have the side effects, and it doesn’t have much in the way of side effects. Very few people say they Notice any including me. I even stopped ADT for eight months While on Daro And my PSA didn’t rise at all.

I’m not saying you have to do it. I was just bringing up the fact that an ARPI can replace ADT since it prevents testosterone from allowing the cancer to grow using testosterone. .If you switched to one, it would allow you to eliminate the ADT side effects and probably still have your cancer under control.

I know a lot of people on Darolutamide alone, Some people on the other lutamides, while they have very few side effects and it works for them.

I was just bringing this up as something to think about. I wish I could quit ADT But my genetic issue sort of requires it.

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