64 YO Gleason 9 . no mets . Did 28 Radiation treatments completed Nov 24, Been on Eliguard since sept 2024. I'm on a 2 year sentence......
Question, How do I know what the best Drug is for this? I'm thinking of switching to Orovyx and have discussed this with the NP who has been administering the Eliguard shots and she is on Board with switching. I'm due for the next shot in June and she said we could move to the Pill then.
Overall, I've gotten used to my side effects but still dont like them, My Understanding is that the side effects will still be there but Orgovyx is easier on the heart, and I should recover faster once I am done with treatment.
Does this approach make sense? it will be 10 months on Eliguard and 14 months on orgovyxx. or should I just stick with Eliguard ( 6 month shot)
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Do you have a heart condition? The benefit of Orgovyx is that testosterone may return to normal much faster than with Eligard. The risk is that missing a pill for even one day allows testosterone to come back (half-life 24 hours).
Nothing that I'm aware of, But I'm on a statin. My My Dad had a heart attack and also his brothers, and My grandfather so I think I'm due at some point..... But so far, nothing identified
Thank you, So do you think Staying on Eliguard is a better option? Or is Orgovyxx a better option, Seems like they do the same thing ( lower T) but in a different way. I'm trying to decide which is better, Any input is appreciated
My doctors consider a family history of heart problems to be a big flag. Considering that the first symptom of heart failure sometimes leads to sudden death, I added a top notch cardiologist to my medical team decades ago. One of my uncles who was in great shape and had been a high school football star died suddenly at age 40 from a heart attack. His mother (my grandmother) died at 78 from a heart attack. I hope you at least get annual checks of your heart.
Can testosterone really come back so quickly (with one missed dose) even if the half life is 25 hours? Even after ending treatment, suppression of LH does not immediately stop.
I've been on Orgovyx for 5 years. Advantages are it acts fast. Early studies showed that it had a slightly longer time of holding PSA down over treatment. 3 months on average. It requires an EKG every 6 months. It is expensive, however if you apply for manufacture assistance it can bring the cost way down through insurance and manufacture assistance. Research this through your doctor BEFORE you go on it. My doctor has a department that does nothing but find ways for financial assistance, and maybe yours does as well. My PSA was zero for 4.5 years and it has very slightly crept up, .03 each 3 month blood draw.Taking a pill is much better than a shot every 3 months. Side affects for me have been super hot flashes which I also had on lupron. They are somewhat less these days. My mind can be fuzzy at times. Ive gained 30 pounds these last 5 years. I am pre-osteoperosis. I've had a full cardio check up and all clear there. All of these from what Ive read are the same as Lupron.
You do need to take it everyday as it's affects dissipate withn just a few days and testosterone returns. However PSA doesn't jump up with that. Take 2 orgovyx one day, to start again, and then 1 each day, and it brings testosterone back down in a few days.
Wishing you the best in your journey. Its all about being positive and a good attitude.
Thank you for the input. I want to do what is best but Just not sure. I wish there was a test to say this medicine works best for you and this is how long you need to be on it. Seems like this is just a guessing game with me leading the way. and I don't know anything..... I would hate to think that i'm just getting the meds that make the DR the most money. But that is where my thinking leads me
When I went on Lupron I was the one that brought it up to my doctor. He had not heard of it or had any patients on it. I requested it because Lupron hit me like a sledgehammer with side affects. I can't honestly say that Orgovyx has been better. However I've been able to get Orgovyx at no cost to me with my insurance plus being on the manufacturer assistance program.
I think you would have a lot less stress and easier decision making if you could eliminate your idea that your Dr is in some kind of financial conspiracy against you.
What I understand is Orgovyx is easier on your heart, but they still have required an EKG be done. I only had one shot of Luprin and I don't know if they require it for Luprin.
Thank you, I keep going back and forth, Make a change for a hopefully better experience, Or stick to what seems to be working and is somewhat tolerable..... I just want to get off this ride....
Other than the pill vs injection and faster testosterone recovery, the difference in CV health is minimal unless you have known heart disease, as was said. More exercise has better preventative power than choice of drug by far.
I’ve been on Orgo for 13 mos. My RO described the benefits over Lupron. I did have blood pressure problems which were cured with meds. Other than that, I’ve had no other intolerable SEs. But, check your insurance for coverage. Orgo is not cheap. If you’re on Medicare, hospital administered drugs by injection are fully covered. Best wishes for your fight against the beast.
ok, my "understanding, layman, not trained, educated, licensed or board certified.
Orgovyx, did 12 months...why I chose that over Lupron...
No flare
Faster to castration
Higher sustained castration rate
Faster recovery of T when stopping though this may be a function of other things, baseline T, exercise...
Lower CV side effect profile.
Disadvantages:
Depending on insurance, approval and financial toxicity.
Requires self-discipline to take every day.
I have TRICARE for Life so no issues with approval or financial toxicity.
I used my Apple Watch to set a daily reminder..
I had Afib, some usual CV "issues" though not concerning to my cardiologist.
So, if you have a family history of CV issues, there is no financial toxicity, you are comfortable with your self discipline to take it every day and your medical team is on board, well then, "just do it...!"
The side effects are likely the same as say Lupron with regards to fatigue, muscle and joint stiffness, genitalia shrinkage, weight gain...I mean, no T is exactly that.
I did not experience loss of libido nor depression on either, the others, yes, were they the same or "better" on Orgovyx? No discernible difference.
As always, diet, exercise and managing stress play a role in mitigating the impact of the side effects. As an aside, I stayed on a daily 5 mg Cialis and with mental and physical stimulation, could achieve erections and orgasms, not the norm though. Now, if my wife...
This is a great conversation to have with your oncologist, not the NP.
In general, SE’s not much different. Orgovyx is expensive, unless you have a history of cardiac disease, or a strong family history of cardiac disease, no advantage.
I have a radiation oncologist who basically told me the urologist is in charge of ADT. I work with the NP as she will sit and discuss this with me while the Dr seems to be in a hurry to get to the next patient...
My personal preference is Orgovyx pill especially over the Firmagon shot once a month. Currently I’m on Orgovyx and Nubeqa. Side effects are tolerated okay: Brian fog, fatigue, weight gain are main side effects. Watch for insomnia, I take a Unisom pill (over the counter); I try to sleep 9 hours each night w/o naps. Heart history: I had 6 bypasses in 2012 and I wear a St Jude defibrillator/pacemaker past 5 years. Ha! But I’m healthy as a horse - working out 3 morning a week.
I switched to Orgovyx at my request, MO had not suggested. I felt extremely tired on Lupron and gained 10 lbs easily. I was considering a drug holiday but thought I would try Orgovyx first(and Orgovyx has quicker onset and leaves your system quicker if I did do drug holidays). I realize both Lupron and Orgovyx have the same end result (lowered testosterone)and this obviously is anecdotal but I have lost weight and have easily kept off after switching to Orgovyx. Fatigue is about same and I seem to have more muscle soreness on Orgovyx. I think if you have insurance coverage for Orgovyx it can’t hurt to try.
Thank you for the input. my last shot wears off in June. At that point I will have 15 months more to do. From what I am reading, I do want to switch but I may wait another 6 months as by december, I will be on medicare and may have better financial options. Seems like the side effects will be about the same. but hopefully , if I switch, I'll be on the pill for 9 months and then when I stop, I will hopefully recover faster
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