I had apalutimide (Erleada) and Lupron about 6-8 years ago. They bought me some time. I had targeted beam radiation prior. Then, Pluvicto in 2021-22. After a scan about 8 months ago showed increased tumor growth, including a tumor on my hip had displaced some of the bone, I had ARC targeted beam radiation for that and some other tumors followed by starting Exgeva treatments to help bone resistance and regenerate bone growth. I've had no noticeable side effects from the Egeva and bloodwork has remained constant for me.
I will continue the Exgeva injections for an indefinite (?) time. I have bloodwork each 6 weeks and will have a scan in 3 week to evaluate the tumors and bone.
I'm also the stage 4 metastatic castration-resistant prostate cancer patient who started the repeat of the Pluvicto treatments 6 weeks ago. Entering unknown territory, to say the least. I received treatment #2 (8 total to-date) this week and will continue the entire 6 again, if the bloodwork stays in the normal range AND the scan shows positive results throughout my body. My PSA is low and has already dropped significantly. I responded remarkably well with the first 6 treatments as a clinical trial patient, which resulted in the decision to repeat the program.
There are a lot options and standard protocol treatments. Do your homework, get a good medical team and stay positive. My personal non-medical advice is, don't wait for anything or anyone and get multiple what-if options ahead of you if and when needed.