Is HT Treatment necessary after Orchiectomey?

[Bdale]

Its been a while since I sent you gentlemen an update. I did go for Keytruda, started it in March of 2022, but stopped in September because of pretty significant skin reaction. My PSA went from 3.31 in February 2022 to 0.09 3 months ago, so it definitely worked. In the meantime I have gone through with an Orchiectomy in May 2023, since my LRP ruined my sex life anyway. I am not taking anything anymore, not sure if that is smart but my MO feels that as long as the PSA stays around that number we won't do anything else. Last week my PSA score went up a bit to 0.19. Now we have scheduled a PSMA pet scan and a bone scan for mid December. I feel great, have absolutely no pain, just a bit weaker than before starting HT. Work out a few times a week, walk with my lovely wife 3 miles eveery day and I sail competitively in the Laser(ILCA) class a very physical boat. Any comments are welcome.

Be well and enjoy every day of Life.

[Tall_Allen]

While orchiectomy (physical castration) lowers testosterone similarly to Lupron, Degarelix, and the like that provide chemical castration, 2nd generation hormonal medicines (Zytiga, Xtandi, Erleada or Nubeqa) slow progression over and above castration.

[Bdale in reply to Tall_Allen]

Thanks TA, I took Zytiga for 2 years and it stopped working, if things get worse maybe I should look at one off the others you mention.

[addicted2cycling in reply to Bdale]

Hi Bdale -- just wondering if u r still Regatta sailing? 🤔 the following is a little Déjà vu from --

*2 years ago

........................................

My unique GL10 treatment included an in situ Keytruda + 2 others back in 2015, and bicycled 121 miles last Saturday so my age + 50 miles extra.

2 years ago

Thanks addicted2cycling, we have a lot in common. I also am an avid cycler, have completed over 28 triathlons including 7 half Ironmans. But my main hobby nowadays is regatta sailing in little Olympic style sailboats together with other old guys. I'm in West Palm right now preparing for a large event. I actually have decided to go the Keytruda route as I have full faith in my MO at the University of Chicago. My reason for my question was to find others to hear what their experience was like. Be well and good luck at the next Ironman. *

btw - that in-situ injection following the castration and cryoablation that I had back in 2015 was Keytruda + Opdivo + Yervoy

I'm toying with the idea of the 2025 Ironman Florida for my 75th birthday -- if still alive 😂

[Bdale in reply to addicted2cycling]

addicted2cycling yes still regatta sailing just came back from France sailed the European Masters Championship. I hope you make the Ironman! Be strong!

[addicted2cycling in reply to Bdale]

AWESOME!!! Glad you're still competing and did you do well?

[Bdale in reply to addicted2cycling]

I finished every race, and had a blast, position was not so important. The folks still in my age group (65-75) are incredibly strong, sailed this boat since childhood. 21 in my age group, I was 17th. The top three had Olympic medals and/or were world champion. You may have the same in triathlons, as you age into a new group the really good folks are the majority. Be well.

[addicted2cycling in reply to Bdale]

My 1st Ironman in 2013 was at age 63 and pre-PCa. If I make it to 2025 ALIVE, should be fewer in the age bracket so even being last I'll be closer to 1st. 😁

[lowT163 in reply to Tall_Allen]

If you had to pick one for someone who has never taken one but has had the orchiectomy and progression what would it be today?

[Tall_Allen in reply to lowT163]

Everyone has to consider the knownrisk of side effects, compliance, and bother and make that decision for himself.

[lowT163 in reply to Tall_Allen]

I’ll pass it on thanks

[MJCA]

Hi,

I read your profile. I’m curious as to what got you onto Keytruda? Was it a particular gene mutation? I did not see mention of BRCA1 or BRCA2. I ask because from what I understand, Keytruda is not “approved” for PCa. Thanks!!

[Bdale in reply to MJCA]

Yess I have a MissMatchRepair and MSI high? I think I put that right.

[swwags in reply to MJCA]

My doc said it would be approved if it came to that but this trial says a lot if you're still castrate sensitive.

businesswire.com/news/home/...

[Pheart2]

Make a decision to add new med and/or on the spot radiation based on new scans results. Meanwhile keep on sailing my friend. Enjoy the life.

[David356]

I assume you had at some point been on Lupron or a sister drug pre orchiectomy. If so, can you comment on the differences, if any, you experienced.

Thanks

[Bdale in reply to David356]

I had Lupron from November 2019 until last May when I had the Orchie, I can't tell the difference, just don't have to go get a shot every three months and the 2-3 days of injection pain afterwards. I live in the western suburbs of Chicago and getting to the University of Chicago is about 80 minutes both ways. Now my blood work gets done at home and my MO talks to me for 5 minutes over video, I only go in for tests.

[j-o-h-n]

to Bdale,

Note: Place your old Christmas ornaments on your key chain. They make a great conversation piece at cocktail parties.......

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/05/2023 2:27 PM DST

[Texasjack1957]

Glad to hear you are doing good. I also had an Orchiectomy in Aug '23. My PSA was 1400. I went thru 40 rounds of RT to the Prostate, which did eliminate the pca but a few months later it metastasized into my back, no organs. I went thru another 25 rounds of RT to my back, but the pain was still debilitating. I decided on the orchiectomy. My pain level dropped from about a 9 to about a 3 within 36 hours and just a little discomfort now.

My PSA dropped to 44 after 30 days. Now my Oncologist wants me to start chemo and ADT and I'm thinking no way! I'm currently taking no pills.

Wishing you the best friend. .