ADT prior to RT

[FredNick]

It has been recommended that I use ADT prior to RT. I believe they are intending to use Lupron but I hear there are alternatives with fewer side effects. Any suggestions and studies to support?

[Tall_Allen]

All forms of ADT have about the same side effects for most men because most of the side effects are caused by the lack of testosterone. Expect loss of libido and hot flashes. Adjuvant ADT has fewer expected side effects than life-long ADT used by men with advanced prostate cancer.

[ToolBeltZia]

Check my profile for my experience with ADT (Orgovyx).

Stay Strong Brother

[Murk]

My Doc recommended Orgovyx becuase he thought side effects were less and he personally witness his patients Testosterone levels bounced back quicker after completion of treatment.

[Vynbal]

I was on Orgovyx for 6 months. Advantages over Lupron are - starts working quicker, T recovery after treatment much quicker (for most men), fewer cardiac SE (pretty rare in any case, but important for men with pre-existing heart conditions). And in my case I have a pretty rare heart rhythm disorder (Brugada Syndrome) and ADT can affect heart rhythm (Long QT) - Orgovyx could be stopped abruptly if I started to have dangerous side effects.

Cons of Orgovyx include reliance on patient compliance- it is best if you take it every day at the same time, missing a dose here or there can greatly reduce efficacy. Also cost, depending on your insurance.

[Dont08759]

I’ve been on Orgovyx for about 5 weeks. For me the side effects are less or non-existent! My MO (Dr. Michael Nissenblatt) who has kept me alive for 35 years (stage C rectal cancer with 2x Metz to lungs 29&28 years ago). Told me Orgovyx is a game changer for the reasons cited by Vynbal. He said everyone on ADT should be taking it. He also told me the main reason it was under utilized is that it is a pill. I asked him to further explain… with Orgovyx, the pharmacy makes the profit, not the practice who charges for the injection. For me that was a sobering thought! Re: time of dose, take it the same time every evening with your statin…

[dhccpa in reply to Dont08759]

Terrible that our treatment is shaped by profit considerations even among standard treatment choices.

[janebob99]

For Lupron ADT, when you eventually quite taking Lupron, your very low testosterone will take a very long time to recover to your original baseline levels. The rule of thumb is that, on average, the time require to recover your baseline T is equal to the duration of ADT. So, if you take Lupron for 2 years, it will take 2 years for your T to recover back to your original levels (on average).

Orgovyx is a very different medication. The time to recover your baseline T is very fast after stopping Orgovyx...on the order of 1-3 months.

Given that ADT causes hot flashes, osteoporosis, muscle loss, fatigue, worse lipids, higher glucose levels, depression, higher cholesterol, cardiovascular events, etc., the faster you can recover your baseline T, the faster you will have a higher quality of life. without these bad side effects.

Bob in New Mexico

T Recovery after stopping ADT

[dhccpa in reply to janebob99]

What's the timeframe on that level of T? How long after stopping hormone therapy?

[janebob99 in reply to dhccpa]

If you expand the Figure that I posted, it says that the time frame is 90 days after stopping Lupron or Orgovyx.

For reference, I've attached in this reply a summary plot showing T-recovery time vs ADT duration for Lupron ADT.

T recovery after stopping Lupron ADT

[dhccpa in reply to janebob99]

Got it. Thanks, Bob

[SanDiegoProton]

I chose to go with Orgovix, it’s a new oral/ Pill once a day. It has short half-life and returns T quicker than the others when stopped. I was on it 4 months. Finished it April 5th. Blood tested yesterday, results next week. I can tell my T is coming back quickly, hot flashes went away quickly too. Insurance may not cover it, $2,500/month if out of pocket, no generic.

[Murk]

I wanted to add that in the USA Medicare covers in house treatments thus if you get a Lupron shot at their office its probably covered. Not sure how Insurance companies cover Lupron shots. But I do know that Orgovyx was recentley $3,100.00 for a 30 day supply if you didn't have a Insurance or a Medicare Drug plan. Some Insurance companies will balk at the price.

I got on with Wellness Drug plan and after paying my monthly costs and deductable Orgovyx dropped to $500.00 a month.

[FredNick]

Does anyone have a link to a study that shows a comparison of Lipton to Orgovyx? This would be helpful with talking to my doctor?

[Mgtd in reply to FredNick]

Sorry could not resist.

My Lipton costs about $8.00 for 200 doses. Much cheaper and I can take it anytime with hot water.