Chemotherapy extends life, but how long is an unknown. Everybody reacts differently. Some people with very serious cases stay on chemo for years. For most people, it’s just a series of treatments.

After chemo there is Pluvicto which, for some people can shrink or eliminate many metastasis. It works real well on 1/3 of people OK on 1/3 of people and not at all on 1/3 of people. It is, however, the next step in treatment.

Where are you being treated? Switching over to a center of excellence could help getting more targeted treatment. You don’t mention the severity of his case. What was his Gleason score? What was his PSA when he was diagnosed? What treatments did he get, What order? Did he get a decipher test, if so, what was the result? After biopsy or surgery, what was found, that can be a major factor in treatment.

It is somewhat unusual for people to have only one year of hormone therapy before it stops working. Most people with prostate cancer live many years, but there is no standard.

I just found out about these two studies. They discuss the fact that if you don’t have the right oncologist treating you, you may not be getting the correct treatments. Specifically if you are not working with a Genito urinary oncologist, you may not be getting the correct treatment. It seems that 43% of people are not getting the correct treatment because their doctors do not understand what treatments can be used and how far the PSA should be brought down after initial diagnosis. It is a real problem for people with advanced cases.

Here are the studies

CSPC
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827619?mc_cid=64e0c6d12c&mc_eid=99575fc699
This is more information on the above study, Maybe it makes it more understandable.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827616?mc_cid=64e0c6d12c&mc_eid=99575fc699