orgovyx 5 months on.time to go off?

[bagogeo]

7/2019-7/2021 my psa was around 1.06..then in 11/2021 went to 1.20...then 1/2022 went to 1.60 I demanded an mri as i saw my velocity rise.Well and behold a 6 mm was seen.Had RP 5/2022..everything was good except a positive margin which they weren't sure if it crossed over per slides.My psa stayed at 0.012 for 1 year till(6/2023).Then i saw a trend 6 months later(12/2023)later to 0.025 ..Then by 6/2024 i was at 0.042.Then requested RT,(with pelvic) which started on 8/2024 for 25 sessions at MSK.I elected to take the orgovyx during the treatment per my decipher score recommendation of 0.63...Day after RT(8/5/2024)PSA WAS 0.009.Now 5 months later still on orgovyx PSA has been at 0.006 x 2 draws..testost has been consistant at 7..Should i continue orgovyx?Some reports say yes some say no.I am concerned staying on it can mask any possible outbreaks,or should i go off and watch the psa/test trends every 2-3 months for a max of 9 months for nadir.(i realize it can be difficult determining nadir when coming off orgovyx).In coming off, if theres a rising trend to 0.1,should i go back on it?Doc suggests another psma scan around 7/25.Which if my psa is still low and assuming i may not be sensitive to it,may not show anything....

[Rams91]

Didn't they tell you how long to stay on Orgovyx? I believe for someone in your case, it is usually six months. And that is only because of your relatively high Decipher, otherwise ADT is not mandatory for SRT with a low PSA of 0.04.

[bagogeo in reply to Rams91]

One radi/oncol said 3 months during RT only....My Doc at MSK didn't recommend for me to be on it,but i insisted per decipher saying better results while psa below 0.1 with ADT and RT together...

[Rams91 in reply to bagogeo]

I was in the same situation as yours. But my RO insisted to take Orgovyx for 6 months based on my decipher score (I think it was close to yours too) with salvage RT when my uPSA reached 0.12 after 18 months post RP. I'm however surprised they started your salvage RT with your PSA at only 0.04. Usually, they wait for 0.1 at a minimum.

[Wings-of-Eagles]

Just listen to your Onc Doc. We here are not experts!