Xtandi vs Orgovyx

[Captj440]

Husband is currently undergoing treatment for recurrence of Prostate cancer with metastasis in spine and right shoulder blade. He's been taking Casadex since mid June and also just completed 5 radiation treatments on his spine. He is also scheduled to begin radiation tratment on his shoulder blade mid October. His oncologist would like him to begin taking Xtandi (4 pills per day) and Lupron shots (1 every 30 days) to lower his PSA level. The last PSA level test was conducted on August 1st (less than 2 months of meds) showing a level of 5.9. I am concerned this is quite an aggressive approach to a change in his current treatment plan, especially without a more current PSA test. I'm also worried about the seriousness of the side effects of Xtandi, not to mention the cost ($3800 after ins). I've been doing some reading and found articles/web pages regarding the success of Orgovyx. It seems the side effects of Orgovyx are less serious and it has a good success rate in lowering PSA levels. Has anyone had any experience or any info to share using either of these drugs? I am also very interested in Pluvicto treatments as yet another option of treatment. I've recently read through 123 clinical trials in regards to his specific prostate cancer so I'm willing to research any treatments/experiences. I appreciate any thoughts. 😊

[Tall_Allen]

Only Casodex? There is no profile -- is this recurrent? At any rate, now that he is castration-resistant, he needs more than ADT.

Orgovyx and Lupron accomplish the same thing (prevent testosterone production), so the Ses are similar. If he has cardiac issues, Orgovyx may be preferable, otherwise it doesn't matter. Compliance is better with multi-month shots than pills.

[Captj440 in reply to Tall_Allen]

Thank you for your response. Yes, this is my husband's second time around with prostate cancer. All had been quiet for over 4 years. He suffered with such miserable side effects with the Lupron shots previously given to him that MO was hoping to avoid that situation this time.

[Tall_Allen in reply to Captj440]

Sometimes the cancer learns to feed on Casodex. If that is the case, his PSA will go down when he stops taking it.

[Concerned-wife]

Are you on Medicare in the US? If so, next year, read this about limit on drug costs. kff.org/medicare/issue-brie...

For this year you can input his drugs on Medicare.gov to see his cost

[Captj440 in reply to Concerned-wife]

Thank you for sharing this information. It's so disheartening that the drug manufacturers are allowed to make such incredible profits at the expense of the ailing and senior citizens! I'll get off my soap box now.😊

[dhccpa in reply to Concerned-wife]

Thanks for posting. Good summary.

[Apisdorsata]

Some tolerate Xtandi well. I took it for 18 months at the full dose of 4 tabs (160 mg) daily. The side effects were awful. By the end of treatment I spent most of my life in bed or on the couch because I was so tired I couldn't function. I was on Lupron at the same time and had previously tolerated it OK. The only way to know how a person will tolerate a drug is to try it. Some find they don't tolerate the full dose but they can take Xtandi at half dose and it is still effective. As I understand it Xtandi has some of it's negative effects because it penetrates into the brain whereas similar drugs do not. What I am sure of is I will not take it again.

[treedown]

I tried Xtandi and Lupron after recurrence and had to stop Xtandi due to the SE's. I am now on Zytiga/Pred and Lupron again (was on it for 2 years after dx) and life is good again.

[Captj440]

Thank you for sharing your personal experience with this combination of drugs. My husband experienced miserable side effects from previous lupron shot therapy so I do understand your thoughts. He too was extremely fatigued and suffered serious bone and joint pain. Due to his recent reoccurence, I am exploring as many options as possible. We feel it's very important at this stage to focus on quality of life 🌴

[j-o-h-n]

Greetings Capitan..... Would you please be kind enough to fill in his bio, (age? location? treatment center(s)? doctor(s)? and etc.) All info is voluntary but it helps us help you and it helps us too. Thank you!!! Regards to the company commander...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/19/2023 6:33 PM DST