That test sounds like a great option. Either of those drugs Can make a difference. Darolutamide has fewer side effects and doesn’t pass the blood brain barrier so it may create fewer cognitive problems. I wonder if they take you off ADT because ADT does affect cognitive function or are they trying to figure out how much more disfunction there is with the second drug.

It’s triple therapy not triple chemo. It includes ADT, one of the lutamides or abiraterone and chemo.

If you get chemo, you can get a cap for your head that you can put in the freezer that will stay cold while you’re being treated and will reduce hair loss. Amazon sells them. Chemo is an easier than it used to be. Yes, there are side effects but for most people, they are not a major issue.

If you were a Gleason 7 then ADT alone would probably be the only drug prescribed. That’s what they did for me and it took 2 1/2 years before it failed, and I had to start on Biclutamide You are a 9 it could recur quickly without the second drug.

If you want to try to eliminate the cancer then chemo is the next best option? There is a disparity of thought that chemo should occur very soon versus later. If you are oligometastatic they usually want to do that chemo sooner. They want to bombarded those nodules that appeared to have gone away with the chemo drug and try to reduce them to nothing. Then there is the new option to do Pluvicto Before chemo, But you don’t have any visible metastasis, so it may not really help as much, it targets PSMA and your scan didn’t show any. You need to ask a doctor about this stuff, Why chemo and what they expect it to do.
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You need to go to a different center of excellence capable place to get another opinion.

Have both of the oncologist that you’ve talked to been a Genito urinary oncologist? Those the ones that specialize in prostate cancer. Following the guidance of a doctor like that can really make a difference compared to just going with a medical oncologist. If you can’t find one come to the Ancan.org Monday meeting and you can get an answer about a doctor to go to in your area. 2 hour Meeting starts at 5pm pacific time, get there five minutes early and you will be first to be helped.