Stage 4 Prostate Cancer and Hormone Therapy quit working

I'm sorry to hear that. My cancer team told me that if/when my ADT+Erleada stops working, there are "lots more" things to do these days — those are just the start of the treatment journey, not the end.

If you're doing your own searching, the keywords you want are "metastatic castrate-resistant prostate cancer" (or "mCRPC") — those will give you the most-relevant results.

I assume he's already had radiation to his prostate, but if not, that's one option. If he has only a few metastases ("oligometastatic"), then they can zap them as well; otherwise, there are treatments like Pluvicto for mCRPC that he can take in liquid form to deliver radiation to lots of small metastases internally. Then, of course, there's chemotherapy, PARP-targetting drugs, and probably lots of other treatments I can't think of right now.

I'm looking forward to reading what others post, because this may be in my future as well if/when my stage 4 prostate cancer becomes castrate-resistant.

As an example of "If you're doing your own searching, the keywords you want are "metastatic castrate-resistant prostate cancer" (or "mCRPC") — those will give you the most-relevant results".- https://www.urotoday.com/conference-highlights/2024-south-central-section/155941-scs-aua-2024-clinical-trial-updates-for-treatment-of-metastatic-prostate-cancer.html?utm_source=newsletter_13520&utm_medium=email&utm_campaign=south-central-section-american-urological-association-aua-insights-in-prostate-cancer-treatment

I was in the Responsive Zone for 2+ years. I am now in the Resistant Zone, started up Oct 23, so I've been in the Resistant Zone for slightly over a year. Both my oncologist aren't worried. We did a PSMA Pet Scan last month, I went from a zillion glowing spots to 9 spots so that's good. I feel great. My local oncologist referred me to radiation to radiate a couple of spine spots. Follow your bliss and may the force be with you.

I’m very sorry to hear this. I’ve had much success with Enzalutimide and Firmagon mind you I believe my diet (Mediterranean) and the addition of naturopathic supplements are helping as well. Specifically, I take Pomi -T, Cucurmin, Quecetin, Super K and Vitamin D. My thinking is the supplements may boost the effectiveness of the Enzalutimide which apparently treats three types of PC whereas Apalutimide treats only two or so I was told. Just thought I would pass this along. Best wishes.

"Enzalutimide which apparently treats three types of PC whereas Apalutimide treats only two"

Thanks for sharing that. It's true, but it matters only if you have metastatic castrate-resistant prostate cancer (mCRPC), which is the one that Enzalutamide is approved for but Apalutamide is not.

Otherwise, if you have non-metastatic castrate-resistant prostate cancer (nmCRPC) or metastatic castrate-sensitive prostate cancer (mCSPC), you can take either (neither is approved for nmCSPC yet, as far as I know).

Hi there
I assumed the issuer of the post had mCRPC - yes/no? Just trying to help if this is the case. Also wanted to pass along diet and supplement routine for the same reason.
Best wishes

Oldfords, First 3 CT scans revealed a zillion spots, that was the first 6 months of treatment. 2 Years after another CT scan the spots/clouds lessoned by half. Two months ago, my PSMA Pet Scan reveal 9 spots. Radiation Oncologist is going radiate 3 spots year in the next few weeks. I am now 3 years, 11 months on this journey. Hope this helps.

"Enzalutimide which apparently treats three types of PC whereas Apalutimide treats only two"

Thanks for sharing that. It's true, but it matters only if you have metastatic castrate-resistant prostate cancer (mCRPC), which is the one that Enzalutamide is approved for but Apalutamide is not.

Otherwise, if you have non-metastatic castrate-resistant prostate cancer (nmCRPC) or metastatic castrate-sensitive prostate cancer (mCSPC), you can take either (neither is approved for nmCSPC yet, as far as I know).