"LUTAMIDES are the latest drugs used I ve read on the internet. My MO told me their not approved by the FDA yet."

The -lutamides, like Apalutamide (Erleada) and Enzalutamide (Xtandi) have been in general use for over 5 years now, and they've shown dramatic results in treating more-complex prostate cancers (metastatic or castrate-resistant). Many of us here are on them.

I don't think any of them is approved yet for non-metastatic castrate-sensitive prostate cancer (nmCSPC) — the simplest and most-curable kind — so that might be what your medical oncologist was talking about.

I've been on Apalutamide since 2021 (together with ADT), and I give it most of the credit for the fact that my stage 4 cancer is in full remission and I'm back to planning for my retirement in a few years instead of my funeral.

You have some interesting information. Apalutamide, enzalutamide and Darolutamide have all been approved, though not for the same thing. It seems all can actually be used in almost all cases.

Apalutamide is approved for nMCRpc mCSPC
Enzalutamide has been approved for nmCSPC mCRPC
Darolutamide has been approved for nmCRPC, mCRPC and mCSPC

I suspect some of these have been approved for more than I have listed.

I am mCRPC and have been on Darolutamide for over a year, all paid for by Medicare. It works great, better for me than Zytiga.