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Posted 9/28/2024 7:58 PM (GMT -5)
You have done great Mr. Pratoman!
your advice is well received. I thank you for reaching out!
Posted 9/29/2024 7:30 AM (GMT -5)
Questions:
1. Pills or injection : which one produces more side effects, or about the same?
also, seems injection is one shot deal and no trip to the pharmacy.
2. How do we know this lymph node is a bad stuff, can it be no harm eventually?
Posted 9/29/2024 10:45 AM (GMT -5)
1. Try reading: https://link.springer.com/article/10.1007/s11523-022-00944-4

2. One would have to biopsy the lymph node to be sure but it is small and in a difficult location to sample. The logical PCa conclusion is drawn from the PSA increases and positive scan result though not definitive.

It may be the only lymph node that shows up currently while neighboring lymph nodes (or other areas) may harbor undetectable cancer cells at this point. The risk is that it will grow exponentially at some point and become a widespread problem thus spot treatments will not be possible.
Posted 9/29/2024 11:49 AM (GMT -5)
Now I got you Mumbo, it is not realistic to same that tiny area.
So I Orgovyx pills should be good for me? instead of a shot...
Posted 9/29/2024 1:05 PM (GMT -5)
There are a fair number of studies and other information on Lupron vs. Orgovyx.

https://www.drugs.com/compare/lupron-depot-vs-orgovyx
https://ascopubs.org/doi/10.1200/jco.2022.40.6_suppl.104
https://www.urologytimes.com/view/relugolix-plus-radiotherapy-shows-safety-efficacy-in-prostate-cancer

The negatives of pills are you have to take every day and they can be more costly than a few office visit injections.

You should have this discussion with your doctor after you review various studies, etc. He will have the most up to date information and stories from his patients to reference.
Posted 9/29/2024 1:21 PM (GMT -5)
I understand the unwillingness to undergo more treatment, however, the scan showing the 'hot' node, plus the PSA increase, strongly suggests the need to treat now, instead of later.

Metastatic cancer never goes away on it's own. All it does is keep trying to grow, and, eventually, kill you.
Posted 9/29/2024 1:52 PM (GMT -5)
The more articles I read, the more confuse I get... don't know what to do now.
Posted 9/29/2024 2:07 PM (GMT -5)
Ok, stop reading articles then. It can get overwhelming when your mind is not in the right place. Discuss with your doctor, share your concerns and ask questions. It will make sense at some point.
Posted 9/29/2024 2:09 PM (GMT -5)
Your doctor is proposing to treat you with hormones to make the cancer more susceptible to the radiation, and then to radiate the hot node.

This is a standard treatment for your situation. The hormone shot vs pills is equally effective. Some men have more negative effects from one or the other--but there are no rules to dictate how they will affect you.

The only real choice is to not treat--and the outcome of that choice is most likely uniformly bad.
Posted 9/29/2024 2:14 PM (GMT -5)
already had a discussion with Dr on Friday....it needs to be treated. pills or shot is equally effective; but pills wear off slightly fast. don't understand what that meant.
Posted 9/29/2024 3:26 PM (GMT -5)
in general, if you take the Lupron shot, it's good for a defined time--3 months, 6 months perhaps. After that, it can take a while--up to several months or longer--for your testosterone to recover to 'normal' levels. It's not entirely predictable.

The pills are something you take every day, they knock your testosterone out, but after you stop taking the pills, your testosterone recovers faster, at least for most men.
Posted 9/29/2024 3:44 PM (GMT -5)
Do I want my testosterone level to stay low as long as possible?
sorry keep asking dumb question…
Posted 9/29/2024 3:51 PM (GMT -5)

jonll said...
Do I want my testosterone level to stay low as long as possible?
sorry keep asking dumb question…

Yes, you want it as low as possible, undetectable. This way the radiation is directed at your lymph area of cancer which will be starved and weakened for lack of what prostate cancer feeds upon- Testosterone.
Posted 9/29/2024 4:10 PM (GMT -5)
Is it a good thing if I take lupron shot?
because it will cause testosterone lever to recover slower than pills.
Posted 9/29/2024 6:26 PM (GMT -5)
I take the shot and I don't care how long it will take to recover my testosterone because that won't kill me or you. My main objective is to get rid of the cancer, which will kill. For me, like Mumbo said, the shot is covered by Medicare. The pills will require me, Starting Jan of 2025, tp plunk down a yearly 2,000 for the deductible. I prefer the part B full coverage under Medicare.
Posted 9/29/2024 6:51 PM (GMT -5)
PaxNova, many thanks!
according to your signature, you started the 2nd treatment in 04/2024, are you done with it?
Posted 9/29/2024 8:02 PM (GMT -5)
I finished the radiation in July of this year. I started ADT, in April. All is proceeding as planned. I get hot flashes but that's it. I walk daily around 3 miles to keep the weight down and a few days a week I work out at home. My psa now is undetectable at <.01. I will finish ADT in March of 2026 (24 months total) although I plan to stop the shots at at 21 months but continue for the last 3 months on the Zytiga pills alone.
Posted 9/29/2024 9:58 PM (GMT -5)
I will be given injection or Orgvyx(6 months) and Radiation (5 sessions).
What do you think ?
Posted 9/30/2024 8:22 AM (GMT -5)
That's what I expected for you. SBRT and a short run of ADT. Glad you are getting something done! In the long run it's worth it. Good luck.
Posted 9/30/2024 8:27 AM (GMT -5)
PaxNova, you had 3 areas to treat and you are doing extremely well! Very happy for you!
Posted 9/30/2024 3:26 PM (GMT -5)
I chose Lupron shot instead of pills. usually how many Lupron shots does one can have?
Posted 9/30/2024 5:54 PM (GMT -5)
You can be on Lupron indefinitely. One member on the forum has been on for some 18 years, but that is rare. Most men aren’t on that long. For example I was on for three years due to my high risk diagnosis. Today it is usually used for 6-18 months unless someone has cancer that doesn’t go into remission. For some men on long term Lupron, their cancer evolves to learn how to feed on things other than testosterone and in spite of no T, the cancer continues to grow. That usually takes several years to occur. At that point different drugs are introduced to manage the cancer.

I would think your doctor has told you how long you will be on Lupron. The shots come in different grades and can last from 1 to 6 months. Since I was going to be on for three years, we used six month shots. Your doctor will help you manage the frequency.
Posted 9/30/2024 6:28 PM (GMT -5)
Thank you JNF,
You have been doing very well... Congratulations!
Posted 10/1/2024 10:22 AM (GMT -5)
I was scheduled for 24 months of hormone therapy, but my urologist (bless his heart) first gave me a one-month shot of Lupron to see if there was a serious side effect. I didn't have anything unusual happen and continued with three-month shots. At that time, Orgovyx was not available.

More in general, if you go with a 6-month shot, it will take longer for your testosterone to recover to a 'normal' level. With Orgovyx, the recovery is faster. This is, generally speaking, a good thing.
Some (I don't know the percentage) never recover though after the shots...

Post Edited (Sr Sailor) : 10/1/2024 11:25:13 AM (GMT-4)

Posted 10/1/2024 10:33 AM (GMT -5)
Hi Sailor, generally speaking, Orgovyx is better because it recovers fast?
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