ADTV vacation is over

[Pianodude]

My bone scan and CT scan in September were so good that I took a vacation from the Orgovyx. I made it to almost 12 weeks and had blood work yesterday morning. My PSA jumped from 0.3 to 2.8. Vacation over. I was hoping for a longer break. Strangely, my Testosterone was still low. 3.9

[6357axbz]

Where is the PSA coming from?

[Pianodude in reply to 6357axbz]

I still have my prostate and while the bone metastasis had been reduced, it is still there. I guess the short answer is that I don't know where it is coming from for sure. I took a loading dose of Orgovyx this morning. Hopefully, I can get things back on track here.

[nobaday in reply to Pianodude]

What is the scoop on Orgovyx? Not heard of it before.

[Hidden]

Could be the beginning of castrate resistance.

If PSA continues to go up you can talk to your doctor about adding second-line ADT Zytiga or Xtandi.

[Pianodude in reply to Hidden]

I certainly hope not. I hope it was just the 12 weeks off of ADT.

[Hidden in reply to Pianodude]

What was your PSA when you started the vacation?

[Pianodude in reply to Hidden]

0.3

[Hidden in reply to Pianodude]

Despite the fact you've been on an ADT vacation, your testoterone is still at a castrate level and so your PSA should not have gone up.

I don't think you have to do anything right now, but I was in the same situation around 3 years ago and asked my doctor if we could check my PSA every month while it was rising. Mine was doubling every 3 weeks.

If you are becoming castrate resistant, there's no exact PSA where you define that. Generally if you have a couple of doublings over 2, it's clear enough to look at the next step in treatment.

[Hidden in reply to Hidden]

Hi Gregg:What are you taking now???

Thanks,

Tom

[Hidden in reply to Hidden]

ADT plus Zytiga. I'm at 3 1/2 years on that treatment and it's still working as far as I know.

[Hidden in reply to Hidden]

10 - 4 - I just finished Doxetaxil in May - 0.45 - so far so good.Keep fighting the beast

[Hidden]

That sucks ! The hope is that the Psa will drop back down again . If it does ,please don’t take a break again .. some have been on adt for decades . Everything we do is a trade off . Good luck , righting the ship brother! 🚣🚣🚣

[Boywonder56]

Funny ypu should post this...just left uo ...for eligard shot.....said 4.5 yrs of this shit was killing me....asked about adt vac from lupron/ erleada.....his words "dont rock the boat"...........picture me ....im pucking up the oar and rowwing on.......peace brothers...

[TJGuy in reply to Boywonder56]

I tolerate Lupron much much better than Eligard. You might do better on Lupron. Or other forms of ADT.

[B8ssist in reply to Boywonder56]

Next September(2022) I should be receiving my last dose of Eligard per my Urologist Oncologist. It will be 2 years from end of my IMRT. Can't say that I will be celebrating, because then the question mark hanging over my head will start to reveal itself.

[Boywonder56 in reply to B8ssist]

Yeah...as petty said the waiting is the hardest part......

[Hidden in reply to Boywonder56]

Clip the Jewels

[Boywonder56 in reply to Hidden]

Not quite there yet...i know some of the gang and i guess you have cut em....they are still my security blanket....although a doiley is about the size of it....

[Hidden in reply to Boywonder56]

Mine is the angry Inch!!!!

[Boywonder56 in reply to Hidden]

Do you think wynn is goingto be sold...have some...getting beat up...just askin

[Hidden in reply to Boywonder56]

Don't know - real estate is my business........

[Boywonder56 in reply to Hidden]

Sorry.......ill stay in line...got shot yesterday....mind all over place .

[Hidden in reply to Hidden]

Keep fighting Brother

[33Ford in reply to Boywonder56]

Had mine removed about 2 weeks ago. I feel much better so far.

[Gearhead]

Thanks for posting. I suspect that ADT vacation experiences are of interest to many of us.

[maley2711]

would PSA increase be unusual.....my understanding is that ADT is not curative but is hopefully a deterrent to growth......the low T and yet rise in PSA could signal castrate resistant mutations? Still ,wasn't rising when Orgovyx was being used, before vacation?

[MateoBeach]

None of us WANT to become castrate resistant. However, being officially declared mCRPC makes one eligible for valuable treatments that are not covered for HSPC. These include Provenge treatments, the soon-to-be-available Lu-PSMA treatments and very many promising clinical trials. If your PSA does not return to your 0.3 baseline promptly when Orgovixis reintroduced, I’d ask the MO to declare castrate resistance and promptly refer for Provenge treatments and get a PSMA PET scan to evaluate and prepare for that avenue.

[nonm in reply to MateoBeach]

The perspective + advise=👍

[Islandboy2021]

I know how where you are coming from. My ADT holiday lasted 9 months while having blood work done every 3 months. PSA was stable at 0.02 until the last 3 month cycle it jumped to 1.2 and made me think why would I jeopardize all the treatments that I have done to get PSA to 0.02 from pre-treatment level of 105. Apparently when diagnosed with stage 4 metastatic prostate cancer taking a ADT holiday is not advisable. I am considered lucky as my PSA has come down to 0.17 since re-starting ADT. But my bone scans show some recent activity from the scans done before the holiday.

As I am considered castrate sensitive there isn’t any other treatments available other than radiation to the Mets on my ribs.

I have noticed that the side effects from the ADT now are greater than they were before holiday.

I know I can deal with the side effects if it is going to keep the cancer from spreading.

Island Boy

[Hidden]

We all have opinions. Here’s mine..... I don’t you are approaching castrate resistance at all. Since you were 0.3 and less than 0.1, you had active metastatic lesions when you took a vacation. Go back to what my research professor told me after 6 years of Lupron/Eligard and the six month chemo with hormone trial when he suggested multiple times of stopping ADT, “ don’t you want to find out? Look, downside is if your PSA rises, we simply restart Lupron injections.”

Well you found out. My suggestions look into systemic treatment to kill the little bastards and restart Lupron/Eligard..... this is certainly a topic for discussion with your medical oncologist.

I wish you the best of luck in fighting this terrible disease.

Gourd Dancer

[Boywonder56 in reply to Hidden]

Hey gourd .....did you find out

[Hidden in reply to Boywonder56]

Yes, I did. I haven’t been on a Lupron/Eligard since February 2010. My guy was right!!!!!!!

GD

[VHRguy]

Studies I'd seen suggested continuous ADT would likely be better for my very high risk, G9 5+4 case, stage 3 (by MRI at diagnosis) case. The dragon seemed to be stirring after a couple years without treatment, so I went back on ADT. At that time, I decided it would be permanent due to the risk of my original diagnosis.

After a bit over 2 years, my PSA is still undetectable. Some of us don't really have the "vacation" option, but it's always a crap shoot.

[blakejr]

I have been on Orgovix for 2 months now. Before I started it my PSA was 7.150. 1 month later it had dropped to .020. Yesterday my reading was <.008. I too am wondering how long the good news will last..