Recently diagnosed with Gleason score of 9

I suggest that you consult with michael steinburg RO at ucla.  As you probably already know, he specializes in SBRT and is head of the department. 

Information note about LU177 that Vasco mentioned. This treatment is available at UCLA. 

Did you follow up on hopeful's (solid) advice?

The (Orgovyx) hormone therapy should bring your PSA down considerably and should be effective until you develop resistance. Hopefully, this will take a long time.

But I have heard that using Orgovyx allows a quicker return to normal testosterone levels, as in a few weeks as opposed to many months when using Lupron. 

How long will you be on ADT/hormone therapy?

Return of testosterone depends on many factors; among others

Age

How long the patient has been on hormone therapy

Hi,

"... Dr says at least six month, ...  ... Should I continue ADT for a total of one year?"

I think that the decision is yours. However you need to consider and avoid becoming refractory to the drug's therapy benefits. 

LHRH antagonist (Orgovyx) and agonists (Lupron) are effective in lowering the testosterone (castration status) which turns to be beneficial in lowering the progression of the disease but it doesn’t eliminate it. There will come that day when the bandit is no more dependent on testosterone to be active and progresses. In other words, these drugs do the intended job well but obscure the real actions occurring behind.

The PSA continues to be the marker to follow. Any increase of the PSA under a castration status (T<20 ng/dL) signify refractory in the treatment requiring attention and in need of a newer strategy to fight the disease.

ADT aims in depleting the body from circulating androgens or in disturbing its manufacturing , obliging the bandit into submission and death. But,  just like normal cells, cancer holds those switches to adapt and survive, to the extreme of creating ways to feed themselves. This condition is seen frequently in cases of prolonged periods on ADT therapy.

You need to check the PSA periodically. T can be checked every six months. 

Please note that these drugs require constant concentrations of its substance in the bloodstream to be sufficient in its purpose. The daily Orgovix pill should be taken every day without missing.

Best, 

VG 

I believe that intermittent ADT extends the usefulness of the drugs, extends survival, avoids refractory, gives relief of the side-effects and avoids the risks caused to other organs or prejudice in other health issues. 

However, the concept/protocol of intermittent ADT is not based on "shorter times" as you comment.  It needs to be adapted to each case differently, depending on the patient past and present condition, as well as involving considerations to future circumstances. Medical oncologists (like Dr Myers and Dr Scholtz) are the experts on intermittent protocols. My doctor uses a protocol similar to the one of Dr Myers in regards to the length of the period on drugs and off drugs. He uses the PSA level instead of fixed pre-set periods to regulate the administration of drugs.

You should get advice from a medical oncologist. ? 

Best

VG 

Hi SV

In your shoes I would check the kidneys filtration rate and creatinine with urine from 24 hours. The numbers above may reflect kidney disease stage 2. You may also check the uric acid as it may accumulate due to lack of filtration.

Best,

VG