Dr. Rana McKay

There are certain things that I think we do in clinical practice because they're just very practical and feasible to orchestrate in the clinic. But, you know, technically at the end of the day, there's like Degarelix that can be given as a one month subcutaneous injection. There's, you know, Luprolide or Trelstar that are given as

Once a month, three months, four months, six month injections, you know, and now there's also an oral agent called Relagolix that can be utilized. What we've seen with the GnRH antagonist is that there does seem to be a little bit more faster time to T recovery post discontinuation of the treatment. And I think there's very controversial data about GnRH.

Once a month, three months, four months, six month injections, you know, and now there's also an oral agent called Relagolix that can be utilized. What we've seen with the GnRH antagonist is that there does seem to be a little bit more faster time to T recovery post discontinuation of the treatment. And I think there's very controversial data about GnRH.

Once a month, three months, four months, six month injections, you know, and now there's also an oral agent called Relagolix that can be utilized. What we've seen with the GnRH antagonist is that there does seem to be a little bit more faster time to T recovery post discontinuation of the treatment. And I think there's very controversial data about GnRH.

the potential cardiovascular, not to say risk, but mitigated risk with antagonist versus agonist. But I think there's a choice in the matter. Some patients may have a strong preference one way or another, and in which case they do, there's options, which is a good thing. Some patients are very

the potential cardiovascular, not to say risk, but mitigated risk with antagonist versus agonist. But I think there's a choice in the matter. Some patients may have a strong preference one way or another, and in which case they do, there's options, which is a good thing. Some patients are very

the potential cardiovascular, not to say risk, but mitigated risk with antagonist versus agonist. But I think there's a choice in the matter. Some patients may have a strong preference one way or another, and in which case they do, there's options, which is a good thing. Some patients are very

fearful of side effects where you may not necessarily want to give them a six-month injection and the way to actually help encourage that they get evidence-based you know treatment is by saying you know what let's just do one month at a time or let's just do the pills and then if you have any side effects we'll just stop so I think that can be very appealing to some individuals yeah totally couldn't agree more I think you know that idea like a bit of a of a trial and

fearful of side effects where you may not necessarily want to give them a six-month injection and the way to actually help encourage that they get evidence-based you know treatment is by saying you know what let's just do one month at a time or let's just do the pills and then if you have any side effects we'll just stop so I think that can be very appealing to some individuals yeah totally couldn't agree more I think you know that idea like a bit of a of a trial and

fearful of side effects where you may not necessarily want to give them a six-month injection and the way to actually help encourage that they get evidence-based you know treatment is by saying you know what let's just do one month at a time or let's just do the pills and then if you have any side effects we'll just stop so I think that can be very appealing to some individuals yeah totally couldn't agree more I think you know that idea like a bit of a of a trial and

You know, very good question. I think there's probably a lot more, you know, hand-waving around the testosterone flare when people first start on an agonist than anything else. You know, I think when it's absolutely necessary are in individuals who have symptoms, urinary

You know, very good question. I think there's probably a lot more, you know, hand-waving around the testosterone flare when people first start on an agonist than anything else. You know, I think when it's absolutely necessary are in individuals who have symptoms, urinary

You know, very good question. I think there's probably a lot more, you know, hand-waving around the testosterone flare when people first start on an agonist than anything else. You know, I think when it's absolutely necessary are in individuals who have symptoms, urinary

symptoms that you're worried about obstruction, metastatic disease, pain, cord compression, that's where it's like absolutely critical to, you know, ensure that you kind of guard against the testosterone flare that can happen. You know, certainly an antagonist avoids that completely.

symptoms that you're worried about obstruction, metastatic disease, pain, cord compression, that's where it's like absolutely critical to, you know, ensure that you kind of guard against the testosterone flare that can happen. You know, certainly an antagonist avoids that completely.

symptoms that you're worried about obstruction, metastatic disease, pain, cord compression, that's where it's like absolutely critical to, you know, ensure that you kind of guard against the testosterone flare that can happen. You know, certainly an antagonist avoids that completely.

you know, I think it has gotten complicated because of the ARSI and the fact that we use ARSI a lot in multiple settings. And, you know, are you going to put somebody on Lupron or biclutamide, then Lupron, wait for their Abbey script to come in and then switch them from the biclutamide to like, what are you actually doing with the biclutamide?

you know, I think it has gotten complicated because of the ARSI and the fact that we use ARSI a lot in multiple settings. And, you know, are you going to put somebody on Lupron or biclutamide, then Lupron, wait for their Abbey script to come in and then switch them from the biclutamide to like, what are you actually doing with the biclutamide?

you know, I think it has gotten complicated because of the ARSI and the fact that we use ARSI a lot in multiple settings. And, you know, are you going to put somebody on Lupron or biclutamide, then Lupron, wait for their Abbey script to come in and then switch them from the biclutamide to like, what are you actually doing with the biclutamide?

And are you actually impacting their survival in any way by giving them the two or four weeks of biclutamide? So I think, you know, not to say that there's been a movement away, but I think we are seeing less utilization of the first generation antiandrogens in the clinic because of the fact that we have these next generation agents and many individuals are getting such agents.