There are people here in the forum who've passed their 10th anniversary with stage 4 prostate cancer and are still going strong.

I've had stage 4 since 2021 myself, and have experienced no progression since then — my PSA remains undetectable (< 0.01). I had the following treatments:

- emergency debulking surgery to the lesion that was compressing my spine
- ADT (Firmagon, then Orgovyx) and ARSI (Erleada) since October 2021, ongoing
- 20 gy of post-op of radiation (SBRT) to my spine
- 60 gy of radiation (SBRT) to my prostate

The advances in my treatment (vs, say, 10 years ago) are the addition of a 2nd-gen ARSI (Erleada), which significantly slows progression and improves overall survival, and recognising my cancer as "oligometastatic" and treating it aggressively instead of just providing palliative care, as used to be routine for stage 4.

I am under the care of a large Canadian Cancer Centre, but I should acknowledge that our hosts at Mayo played an important role in standardising more-aggressive treatments for stage 4 prostate cancer like mine rather than just "keeping me comfortable."