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Will Orgovyx (relugolix) Reduce Prostate Cancer without Radiation?

Posted by rnpalarino1 @rnpalarino1, May 11 8:05am

I am 77 years old. I had my prostate removed over 3 years ago. After 2 years my PSA began to rise from < .01 to .93. My oncologist at Mayo Clinic, Jacksonville has me on Relugolix. After taking the Relugolix for about three weeks I feel some tiredness in the afternoon, a couple of hot flashes and less libido. But otherwise I have been exercising and playing golf. The doctor will check my PSA and testosterone in about 2 months. I cannot receive radiation because of a previous operation to remove my colon. I have a J-Pouch. The radiation could damage the J-Pouch.
My question is will the Relugolix eliminate or slow the cancer growth without radiation treatments?

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heavyphil | @heavyphil | Aug 7 3:40pm

Yes, it definitely will but will not kill it. As others have pointed out you can develop castrate resistant PCa being on hormones for an extended period.
There is also a ‘bipolar’ type of treatment which gives you 6 months on and 6 months off which might prevent castration resistance. Everybody’s different and there’s no one size fits all.

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northoftheborder | @northoftheborder | Aug 7 4:02pm

(layperson here) Outside of the prostate itself, they generally reserve external-beam radiation for low-volume (oligometastatic) prostate cancer, so you're not alone — people with high-volume metastatic cancer can't have external radiation either.

Strictly speaking, no metastatic cancer is "curable" either with or without radiation. I hope that will change in the future (RNA treatments, maybe??). But for now, their goal is just to keep our cancer at bay so that we can live out our remaining years, hopefully as many as we would have had without prostate cancer.

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shelby29 | @shelby29 | Aug 8 8:42am
In reply to @northoftheborder "An ARSI can extend the effective period of ADT like Orgovyx by many years by delaying..." + (show)
@northoftheborder

An ARSI can extend the effective period of ADT like Orgovyx by many years by delaying castrate resistance and then inhibiting its effects, but obviously the choice depends on your tolerance and other factors.

It's worth raising the topic with your onco team, at least.

Jump to this post

Radiation, ADT (Eligard) and Zytiga. 10 months later had a heart attack and the took me off Zytiga. Mayo said all ARSI drug are bad for the heart. So not Eligard only. Scary, Gleason 8, stage 3b.

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northoftheborder | @northoftheborder | Aug 8 10:25am
In reply to @shelby29 "Radiation, ADT (Eligard) and Zytiga. 10 months later had a heart attack and the took me..." + (show)
@shelby29

Radiation, ADT (Eligard) and Zytiga. 10 months later had a heart attack and the took me off Zytiga. Mayo said all ARSI drug are bad for the heart. So not Eligard only. Scary, Gleason 8, stage 3b.

Jump to this post

Yes, that's true — Erleada (Apalutamide) lists a prolonged QT interval as one of its possible side effects. As I mentioned in a different thread, I had a full cardio stress workup at the university heart institute, and my heart is tolerating it well so far.

Given that my remaining life expectancy at this point would likely have been 2–4 years without Erleada (they originally told me 5–7 years. and I'm almost 3 years into that), I'm *very* willing to take the small extra risk of future heart problems in exchange for what is now looking like many, many more years of high-quality life.

Obviously, if my heart were already seriously damaged, the equation might change.

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