How long can I delay my Lupron shot ?

[mynacho]

I am a stage 4 PC patient diagnosed in August 2021 and have been on ADT double therapy ever since.I get Lupron shots every 3 months and take 2 tablets of Apalutamide (Erleada ) evey day. I have been lucky that I responded well to the treatment and have been undetectable ever since. I never had RP or RT or Chemo .For some stupid mistake with the Medicare Advantage plan I had, I lost my part B coverage without knowing and trying to get reinstated but unfortunately Social Security told me it may take up to 6-7 weeks .I have applied last month so it will be late September by the time I am reinstated. I am already past 3 months so if I leave it till then it will be 4.5-5 months between shots.Is there a risk in doing so ? Or is it maybe even better if my PSA rises a little so I can get a PSMA scan to see if there are any spots cos my CT scans does not show anything ?

In the meantime I would still continue my daily Erleada of course, so it will not be a total vacation !

I would appreciate your thoughts in this matter.

Thanks to all the warriors and wish them a happy life

[Tall_Allen]

Of course there is a risk. You may be able to get Orgovyx tablets under Part D or as part of your Advantage Plan.

[mynacho in reply to Tall_Allen]

I was hoping you would answer cos you are the most knowledged! My Advantage plan is lost also but I do have Part D . I will ask my doctor about Orgovyx but I am also travelling by the end of next wek so not much time.I see many people do BAT or mono therapies but my MO is not open to try anything else while this one is working. My CT s and even my Prostate MRI showed no cancer but I would like to have a PSMA but they say it is not much use if you are undetectable. Thanks

[Tall_Allen in reply to mynacho]

BAT is only in clinical trials. No point to PET scan.

[GP24]

Erleada is more effective than the Lupron shots. I would not worry if you omit Lupron for two months.

[mynacho in reply to GP24]

Thank you that is relieving to hear.I would sometimes stop Erleada for a few days when my mouth sores get worse as SEs but I will now be more stringent not to have a gap during these few weeks.I read if you are on ADT more than 18 months (and I have been on it for 36 months now ) it takes quite a while for testosterone to rise and hence the PSA

[GP24 in reply to mynacho]

"Quite a while" is more than six months. "Conclusions: Although over 50% of men never achieved testosterone recovery, we observed a median time to testosterone recovery of 9 months in men who achieved testosterone recovery. " ascopubs.org/doi/10.1200/JC... or: pubmed.ncbi.nlm.nih.gov/267...

[NecessarilySo]

I would say let the PSA guide you. When your PSA reaches detectable (.2) you should return.

[SteveTheJ]

As TA said there's a risk but it took ~7 months with no Lupron for my testosterone to start going up. (Oncologist recommended a break after two consecutive years of no tumors on scans.) I wouldn't sweat it too much; just start back on Lupron as soon as you can. And take any other advice TA gives.

[JustAnotherCancer]

on a different matter. How do you lose part B with Medicare Advantage?

It’s inclusive.

[mynacho in reply to JustAnotherCancer]

I don't really know how it happened cos I was on autopay and my advantage plan( Cigna ) paid some of my part B .Maybe my credit card on file expired or something and my payments did not go through and they did not let me know and I changed my address and forgot to update my profile so did not receive any bills either and medicare terminated me for non payment.When I found out I paid it all but you have to apply to SS for reinstatement and processing takes a few weeks unfortunately. Anyway I will stay away from Cigna for the future and maybe choose a different advantage plan or carry on with basic Medicare Plan B until new year.In the meantime I added another Drug plan

[Ingress]

sounds like BS to me.

[mynacho in reply to Ingress]

??