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@russ777

I appreciate your elaborating on your treatment options. Only additional comment I'd make is that if you do indeed have the BRCA2 mutation then I'm surprised your care team has not suggested you look into PARP inhibitor therapy. I'm not that familiar with the SOC protocols for using a PARP inhibitor in conjunction with other SOC therapies, perhaps it is more of a last line of defense therapy.

I'm stunned that you've been dealing with this since your early 40s. Hats off to you and absolutely, 80 is a realistic goal if you have an oncology team that knows how to best employ the various therapies. I know an individual who has been battling Gleason 9 disease for almost 30 years. He was told by his urologist when first diagnosed back then to enjoy Christmas because it would be his last. He's probably outlived that urologist.

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Replies to "I appreciate your elaborating on your treatment options. Only additional comment I'd make is that if..."

you are welcome and yes.

Looking down the road, presuming the ADT remains effective for the 24 month period, I'll go off the medicine, but if the PSA rises, I’ll go back on ADT treatment. If at some point the PSA rises while on ADT, I'll add to the mix a combination of drugs of an Androgen Receptor Inhibitor (Enzalutamide) and PARP inhibitor (Olaparib). There is also a possibility that when/if my PSA rises after being on ADT, I might opt for an updated PSMA PET and if there are just a few locations, then radiation will come back into the conversation.

Onward to outlive my health team!