Orgovyx didn’t lower testosterone

[Farmer3419]

My husband had RP Dec 2020, unfavorable pathology report and high decifer test so he started Orgovyx and then had radiation this summer. They just tested his psa, thankfully undetectable, but his testosterone which started at 253 only went down to 247. I guess that answers why he had no side effects from the Orgovyx. My concern is for any doctor waiting 5 months to do blood test to be sure ADT is actually working. Also if his psa starts to rise, will another form of ADT actually work?

[pjoshea13]

Presumably, he has been taking 120 mg daily? Maybe his liver is clearing it super-fast to have no effect at all.

Yes, there are ADT options that act differently.

His PSA is undetectable, so why does he need to be on ADT right now? ADT is palliative & is not usually effective in the long run. Perhaps it is something to keep in his back pocket?

But I'm interested in the thinking behind his treatment.

Best, -Patrick

[Farmer3419 in reply to pjoshea13]

Yes, he was on 120 mg. Right now he is not taking anything for ADT. But they have said if his psa becomes detectable we will have to look for another approach.

[Tall_Allen]

That's unusual. His adrenals may be producing an unusual amount. Maybe switch to Lupron + Abiraterone- it may do the trick.

[LearnAll]

He might be fast metabolizer or he might have malabsorption. Relugolic(orgovyx) is basically similar to Lupron like meds. The same mechanism of action....and therefore ..it is expected to decrease T.Firstly, if PSA is undetectable he just needs to monitor PSA frequently (like once a month)

If it shows clear and continued rise, then, next treatment should be Zytiga (abiraterone) as Zytiga uses a totally different path (blocks CYP17 enzyme) and is most likely it will lower his rising PSA. If I was in his situation, I would wait and only try to improve general health, eat anti cancer foods, keep C reactive protein below 1.0 and exercise 1 to 2 hours each day.