Going from Orgovyx to Eligard with Zytiga

Hubby started Orgovyx in April (which was after casodex and nilutamide were no longer effective monotherapies). However, PSA is starting to climb. He plans to switch to the six-month shot of Eligard plus the oncologist is thinking they may need to add Zytiga/prednisone. We'll know for sure on the Zytiga after his January 24 PSA. The switch to Eligard is due to upcoming international travel that will keep us on the road for several months. My question: how effective has this combination been for anyone? And how are you feeling? Thanks for all your help.

Should you add ZYTIGA ~ or its generic version known as "ABIRATERONE ACETATE" ~ we have a detailed thread to share with you here.

One consideration ~ my oncologist is reluctant to give me a multi-month dosage of the ADT shot I am on, as he is concerned I might experience fatigue. For this reason, I receive an injection each month instead.

It's not as convenient, granted, but I continue to stay involved at my school full-time, and consistent levels of energy are paramount to me. Simply something to ask your oncologist about!

Also - my first two forms of ADT did not suppress my PSA fully ~ as evidenced by "spikes and flares" in my testosterone levels.

It became essential to try three different forms of ADT, in my case. Lupron and Firmagon didn't fully work for me. In the end, after careful tracking, ZOLADEX worked far better, in my particular case.

My oncologist emphasized the importance of not "locking" into a multi-month dose of ADT, until its efficacy and impact upon my testosterone levels had been tracked and assessed.

My lesson learned? Make certain you ask that testosterone levels are tracked, along with PSA levels. ZOLADEX flatlined my testosterone and that's what has helped me maintain my health goals, because it helps keep my PSA controlled.

On FIRMAGON and LUPRON, my testosterone was spiking up into the 30s and higher, and my PSA flared. ZOLADEX knocked my testosterone below 7, where it has remained for years.

Just some first-hand experiences to share ~ in the hopes it helps you reach the treatment combination that works best for you.

I owe everything to my oncologist who worked so diligently to carefully track these things, for my benefit ...

Keep in touch with us here ~ we're in this together, one & all!

CYCLONE ~ # Iowa State University

I'm thankful to read that the testosterone levels are staying "knocked down" in your case.

It's so easy to focus on one's PSA level, and asking for an occasional testosterone test is often overlooked - even by doctors.

I encourage everyone who is on any form of ADT to ask for a testosterone level test. Make sure it's LOW ~ testosterone is the fuel that feeds renegade prostate cancer cells.

My oncologist has my testosterone level assessed every time I visit the lab for blood work and PSA tests. For years this was assessed every month - now I visit the lab every two months. There's consistency there, and for my case, that's essential.

I get to the lab a bit early ~ then I visit a coffee shop or read a book. Then, a bit later that day, I see my oncologist and he shares all lab results with me in person.

This system works for me. Lab results shared from that very day.

My original urologist failed to track testosterone, along with PSA, upon my diagnosis. He also refused to use anything but LUPRON. That's the day I transferred all my care over to the oncology department, which opened many new possibilities for me.

My oncologist is the one who discovered that LUPRON wasn't fully suppressing my testosterone, which created worrisome "spikes and flares" in my PSA.

From there, we tried FIRMAGON. The same thing occurred. I also experienced painful site injection reactions with FIRMAGON ~ large swellings the size of a golf ball ~ which felt like I had been stung by a hornet in my abdomen.

Last of all, ZOLADEX was tried. It's a "pellet" injected in my abdomen every month, and it flatlined my testosterone levels. For me, it has kept my testosterone consistently LOW (below 7) for years.

They numb me up with a tiny shot of LIDOCAINE first, in my abdomen, and then the ZOLADEX pellet is injected painlessly.

In my case, the "third time was the charm!"

My lesson learned? Make sure you are having testosterone assessed, if you are on ADT medications or injections.

IF your testosterone levels are high, I found that trying other forms of ADT was easy, if required for your case.

Let us know how your consultation goes in later January.

In my case, ZYTIGA was added to my daily medication regimen.

I was the first fellow to try ZYTIGA at my clinic, and I have remained on ZYTIGA (now the generic version ABIRATERONE ACETATE) for over seven years.

Keep us posted on your upcoming consultations.

I can tell from your posts that you are staying right on top of everything ~ keeping an open mind ~ asking insightful questions ~ and embracing new treatment options, as needed.

Support, handshake, & fellowship ~
CYCLONE ~ # Iowa State University

mbock,
I am claiming ahead of time that the powerful Zytiga will plummet the PSA way down. Aint no easy ride though, Get ready for fatigue. hang in their , Keep up the good fight, keep the faith
Wings

Mbock,
Ditto what Mr Wings posted. I would encourage you to look over the thread regarding Zytiga that Mr Cyclone mentioned.

Hello, MBOCK ~

Glad you are forming a battle plan.

I imagine you could try CASODEX for a month or two, and closely monitor that PSA level.

Up until very recently, my PSA was recorded every four weeks. But, I am still here ~ and my medical team has watched over me with vigilance and compassion.

I think keeping the "ZYTIGA plan" ready is proactive. With a rising PSA, you might need that weapon, after giving CASODEX a try.

I think timely follow-up appointments would be to your benefit, at this time. You want to get that PSA knocked down.

Also - my oncologist noticed "spikes & flares" in my testosterone with LUPRON, so we tried FIRMAGON next, which didn't work and better.

From there, ZOLADEX was tried, which has flatlined my testosterone to less than 7 for the past several years, which has also helped control my PSA, in combination with my other treatments ~ which is detailed in my medical history beneath my signature.

Here to lend my support and encouragement!

Standing alongside you ~

CYCLONE ~ # Iowa State University