Stage 4 Prostate after a year has Metasasized to Lymph Node

Did he receive RT? He should have to slow it down. I had 28 RT visits plus Arbiterone once a day with prednisone. PSA < .01

Was radiation discussed? If he failed apalutamide and ADT , why not radiation to the area where the lymph nodes are? I do not know the details but I have had metastasis to lymph nodes twice and twice I got radiation. 39 sessions first and 5 the second time. Radiation can be given especially with low volume disease, that means less than 3 lymph nodes detected. I am stage 4, Gleason 9, doing well after surgery failed to cure me. Best for you husband. He should do well too. Stay positive.

Although mine is in bones I am on 4th injection of Radium 223 or Xofigio Look into that

If it fails after 18 months then LU 177 Chemo would be last

The hormone treatment can last 3-4 years in some cases with some forms of PC, but there are some forms of PC that adapt and find a way around the hormone treatment much faster. For my husband, the hormone treatment worked very well for 9 months, then PSA started to rise quickly. Because he was BRCA1 positive, he was put on Lynparza. That slowed progression but never worked as well for my husband as it has for others. After the Lynparza stopped working at all, they switched him to chemo.

My husband is on Abiraterone and prednisone and Lupron and has been for several years. These medications kept his Stage 4 cancer suppressed for three years. It has now recurred and he has had three of six Pluvicto infusions so far. Because he had docetaxel several years ago, he was approved for Pluvicto without trouble under the current FDA regulations.

What is OS survival rate for this Lu 177 your on Any side effects

cal77: where is your husband being treated. Is it at a center of excellence?

That likely means he has become castrate resistant, thus ADT may need to be continuous.

Question is what now. An option may be to do radiation, either say SBRT to the PLN identified in the scan or whole pelvic lymph node radiation. Consider consulting with a radiologist.

If has not had genomic testing done, talk with the oncologist about doing so. That may identify pertinent clinical information and provide more tailored treatment options - https://www.pcf.org/patient-resources/family-cancer-risk/genetic-testing-prostate-cancer/

Kevin

We learn from each others stories. I am 70 years old, 3.5 years into my prostate cancer journey. I was on watchful waiting for 10+ years. Prostate Cancer Diagnosis (Stage 4) happens, within two weeks I began Radiation (24 rounds, 1 month), Chemo (3months), ADT ever since. Year one was full of ups and downs, depression, pain, and little hope. In fact it was so bad I choose not to hope. Year two, discovered wellness full of ups with few downs, depression and pain became very manageable, mostly it was me + caregiver wife learning how to manage the pain and live with cancer. Year three +, epically wonderful, made it to survivorship acceptance. Hopeful, Helpful, and Healing is a great place to be in this journey.

I trust this will help.
My prostate cancer also spread to Stage 4 in the lymph nodes. I will be surprised if your oncologist does not recommend radiation treatments followed by hormone suppressants, such as Lupron Depot shots and Abiraterone.

I am 1.5 years into this protocol and my PSA is non-detectible and technically in remission.
Prayer is also prescribed.
Blessings.