← Return to 11 anniversaries since diagnosis of stage 4 prostate cancer

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@wooldridgec

Stage 4b oligometastatic is curative. Deep remission. Unfortunately, I am high volume. I had my recent checkup and I am still < 0.100. I also meet with our :Life with cancer" group and I was encouraged and also discouraged by the meeting. Basically, they told me that I need to accept that the cancer will return some day. They do not know when but it is inevitable that everyone becomes resistant (castrate resistant). Resistance occurs because you already have resistant cancer cells that are not killed and left over after radiation and or chemotherapy. My strategy was also the throw the kitchen sink at it "Carpet Bomb" the cancer with radiation to the spin and ribs and enduring 10 chemotherapy cycles instead of 6. I told my wife I did not want to leave any resistant cancer cells behind and give them a chance at returning and causing resistance sooner rather than later. I had quadruplet therapy not triplet. Radiation, ADT (Eligard), ARSI (Darolutamide), 10 cycles of chemotherapy (Docetaxel), and Xgeva injections for my bones every 6 weeks. I did 22 infusions of Zometa before being switched to Xgeva. I do not want to accept that I will become Castrate Resistant.

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Replies to "Stage 4b oligometastatic is curative. Deep remission. Unfortunately, I am high volume. I had my recent..."

They told me in 2021 that my cancer would likely become castrate resistant within a couple of years. Now they don't say that any more.

Granted, my situation is different, with just one known (very large) metastasis, but things really are up in the air these days, eapecially because drugs like Erleada are still new.

I am 4b as well. I had essentially the same therapy as you (Johns Hopkins calls it Total Eradication Therapy-TET). My PSA is currently undetectable one and a half years after treatment and I am off all meds. My MO at Hopkins is heavily involved in research and I have read some of his articles. When cancer cells are stressed (chemo, radiation etc) some of them go into a hibernation state with double DNA; the cells look different under the microscope than the other cancer cells. After a time (don't know how long) when the stress is no longer present they begin dividing again. That is why some MO believe it is futile to have excessive chemo treatments which can have significant side effects. No matter how many you get you won't kill them all. The first 4 or so treatments kills 99% of what the chemo will do.

Good luck to you.