71 year old diagnosed with prostate cancer, G9, 3 years ago. Initial imaging revealed no evidence of spread. PSA 7.5 at max. Had RP in October 2021. In March 2022, after PSA went up to 0.37 from undetectable after surgery, a PSMA PET scan revealed a solitary met to T8. I had successful SBRT to the vertebra and 4 months later the PSA had rapidly increased to 4.5 Repeat PET scan showed new positive node in pelvis.

Did research and sought treatment at Johns Hopkins. The MO immediately began aggressive triple therapy treatment with Docetaxel chemo, Darolutamide and Lupron. PSA went undetectable after second chemo treatment. Off chemo and Daro after 3 months and Lupron after a year. Had whole pelvic radiation 8 weeks after finishing chemo.

My PSA has remained undetectable (even with ultra sensitive test) ever since. My testosterone hasn't recovered-last week it was 52. My MO said they have killed the aggressive clones and my long term prognosis is good. Possibility I am cured and cancer won't return. If it does he said it will be slow growing/indolent and they can manage treatment. He has started me on T replacement therapy.

My MO has extensive experience treating oligo metastatic disease with aggressive triple therapy as soon as diagnosed. This made sense to me. Attack aggressively early and kill as much rapidly dividing, aggressive cancer cells and micro metastasis. Treat the primary tumor with surgery or radiation. Kill any limited mets with radiation. Starting me on TRT is controversial but living long term with very low T as significant deleterious health effects and QOL issues. I treat him and his team completely.

I am just trying to get on with life and live each day. I look forward to stating the T next week. I have been miserable the last 2 years with very low T.

Good luck to everyone fighting this beast.