Am I becoming castrate resistant on orgovix?

[Startech]

I moved again and hopefully this will be the last time. So, I have had to put together a new Medical team and meet my new MO this Tuesday. My bio is pretty up to date. I'm stage 4 and have some lymph node mets and some bone mets. It's been over a year since my last scan which showed improvement from Taxotere and Orgovyx. I was doing well low T <10 and PSA .02. I had a lady friend come visit and took a 40 day break from the Orgovyx. I retested the day she left and my T jumped up to 502 and my PSA jumped up to .312. That was last August 2023. Dec. 2023 the T went back to 13 and PSA .06. They only tested my PSA in Jan. 2024 almost doubled at .11. My last test in Feb. T had risen to 19.7, but PSA remained at .11.

What do you all think of my situation and are there any questions I should be sure to ask my new MO. Wishing you all the best battling this stuff.

[Cooolone]

You resumed ADT? Orgovyx? Are you using Orgovyx as a mono therapy? Or using inhibitors as well?

Bottom line is if your using ADT and T is increasing, it's a problem. As evident when you took your foot off the pedal and stopped ADT the PSA rose. With the increase in T, the same will happen over time.

Just thoughts... Not any explanation on what to do.

Good Luck

[Startech in reply to Cooolone]

Thank you for your reply. Yes I continued Orgovyx as a monotherapy. I agree with you that because T is rising although PSA is remaining stable, that could be a problem.

[j-o-h-n in reply to Startech]

"any questions I should be sure to ask my new MO.? Yep, how much does he/she charge....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Startech]

Okay, here's another update after meeting my new MO and an f-18 PSMA pet scan. It has been 18 months since my last scan showed Mets to my lymph nodes and bones. This new scan showed that all of the Mets are gone except for a slight up take in the pelvic region. The doctor who read my scans was not given my history evidently and only commented that there was concern for recurrence after surgery.I just completed a PSA and testosterone test yesterday which showed the testosterone had dropped to 12 but the PSA had increased to .18.

My new MO has gotten a CD with my scans from August 2022 to compare with my latest scans at a tumor board meeting coming up next week. So I guess I'll have to wait until after that to hear what he is thinking.

I am hopeful that the new scans showing distant metastases gone is better news than the rising PSA.

Thank you all for taking the time to read my post and of course I wish you all the best.

[Startech]

Okay, as of May 30 of this year my T has risen to 19.7, and my PSA has risen to .29. Does this mean I'm becoming castrate resistant? My latest scan showed a small uptake near my vas deferens but no increase from my scan 3 months before. What's next?