Relugolix (Orgovyx) before Abiraterone (Zytiga)?

I don't have any experience with Orgovyx, but I anticipate that it works similar to Lupron. I have experience with Abiraterone, and it is not taken well by all patients. My guess is that your team wants to see how you react to Orgovyx, before adding Abiraterone. If you react well to Orgovyx, then they will start Abiraterone (and Prednisone, as Prednisone usually stops Abiraterone from upsetting the natural functioning of your liver and kidneys), and they will monitor how you react to the Abiraterone. If you suddenly start having issues (liver and kidneys) after adding Abiraterone, then they will most likely stop its use.

In my non-medical opinion, this approach makes good sense (versus adding two reactive chemicals into your body simultaneously), and delaying the addition of Abiraterone for a few months won't make any difference in the final outcome. You may be on that cocktail for up to two years. I was directly placed on the Lupron/Abiraterone/Prednisone cocktail, as I had previously been placed on Lupron, and I did not have any issues with it. I was on that cocktail for two years.

The good news is that cocktail appears to work quite well, as I had my PSA checked today, and I am still undetectable. I have been off of that cocktail for two years now, and I am super excited to still be undetectable.

Yes, it metastasized with a lesion on my pelvic bone. That is why I was placed on the hormone cocktail for two years, along with 30 Grays of SRBT radiation on the lesion.

Hi again,

I agree with above opinions. Your doctor may want to postpone Zytiga, to verify if your case is castrate sensitive.

Nowadays the hormonal treatment incorpores a series of newer and more specific drugs taken alone or concomitantly with the ADT protocol (Orgovyx in your case).

The choice varies from case to case, depending in whichone we "become" classified; castrate resistant or sensitive. In other words, which blockade seems to be enough or works better.

Casodex (bicalutamide) is the old antiandrogen still in use but that is being substituted by the more efficient androgen receptors AR antagonists.

There are Erleada (apalutamide), Xtandi (enzalutamide) and Nubeqa (darolutamide). All these block directly the androgen receptors (the mouth) of prostatic cells. These are typically recommended to castrate sensitive prostate cancer cases, even for those who have metastactic disease.

Another group of androgen receptors antagonists are the CYP17 inhibitors that are more selective to the various androgens circulating in our body (DHEA, etc), precursors to the testosterone.

These include Zytiga, Orteronel, Seviteronel and a fewer more now under clinical study. Zytiga, in particular, have shown success in cases of disease progression under ADT. A state called as metastatic castration-resistant prostate cancer (mCRPC).

Some oncologists still add one more blockade drug, the so called 5-alpha reductase inhibitors such as Avodart (dutasteride) or Proscar (finasteride), which avoids the "manufacturing" synthesis of a more potent androgen, the Dihydrotestosterone.

Well, they all got attached side effects that may be prejudicial to other body functions. Periodical lipids monitoring is required.

Best

VG

You are welcome. Along my journey of failed treatments, I become curious and devoted to all things related to prostate cancer. I did and continue doing lots of research.

You can take from my above post that there will be always a substitute for a failed therapy. We just need to be vigilant, keep the bandit on the canvas and try keeping the quality of life as a prime goal.