Treatment Decision

[Nickberti]

I am hoping for some guidance for what to do next for my father.

My father is in his early 70s, Gleason 8, PSMA and MRI last year showed no spread, but PSA was rapidly raising.

He had an organ transplant years ago, and a small stroke, takes anti seizure medications, and has a walking disability due to a neuromuscular disease. He already wears diapers for incontinence.

He has been on Orgovyx for 9 months now and two months ago he underwent 5 sessions of MR-Linac treatment.

PSA is now zero, Testosterone is also zero.

We noticed some mental/cognitive decline in my father and the doctor suggested we stop Orgovyx now at 9 months instead of going the full 2 years course.

What would you recommend we do?

Thank you!

[KocoPr]

I would also add darolutamide since the OC suggested stopping Orgovyx. That should hopefully increase his testosterone and darolutamide would still inhibit the androgen receptors everywhere but almost nothing affecting the brain. What i mean is darolutamide very minimally crosses the BBB thus the testosterone he will start making since Orgovyx is stopped will be converted to estrogen in his brain which will be good for his mental health.

[Nickberti in reply to KocoPr]

He wants to keep the Nubeqa as an option when/if the cancer shows up again.