Interesting situation and good outlook on having faith on the light leading forward. I tend to agree that the PSA from June 2023 to April 2024 was a huge increase, however you and your health team embarked on a triplet therapy and your current PSA of 1.26 is definitely a sign of success, however it is remarkable that that your most recent PSMA PET shows the same areas of uptake as your PSMA PET from April 2024. I have heard of cases where PSMA is 85-90% effective on identifying prostate cancer, however your situation is different. I would want to make sure that the most recent PSMA PET results are analyzed again, and at the same time I would suggest to embark on PSA tests every month (your PCP can place this order). Hypothetically, if your PSA remains low and does not increase, I'd almost discount the PSMA PET results, but that line of logic is something to review with your health team on a slow and intentional conversation.

Are you still on Lupron and Nebeqa? If so, is the health team suggesting to stay on it? You sound like you are still in the MHSPC phase of the cancer, so sticking with those treatments would be a good step and then exploring MHRPC drugs when/if their efficacy fades.

Keep active and overcoming the fatigue and brain fog

thank you for sharing and asking

dave