At this point, some doctors recommend removing the prostate to eliminate its ability to produce PSA. The next thing is to try and zap the metastasis. They might do radiation to eliminate the prostate and then radiate the prostate bed. After that, they can use SBRT on some of the other metastasis.

This depends a lot on how many metastasis there are and where they are located. If there are more than six or seven than this is a real problem. And most doctors will not start zapping a lot of metastasis.

Another step is Pluvicto. It’s a treatment that can handle many metastasis at once, In the six treatments, he can get. It works really well in 1/3 of patient. It works OK and 1/3 and not at all in 1/3 But it is the next step usually in treatment unless they can do the above things first.

He should get both a Hereditary and a somatic, genetic test. If any of them show that he has BRCA, he can probably go on a PARP inhibitor which can give him some more time.

With a case like this, you should be meeting with a Genito urinary oncologist, They specialize in prostate cancer as medical oncologist, work with all different cancers and can’t specialize enough for a case like your father has.

You should get a second opinion from a center of excellence. There’s many places you can go, but another option would be to Go to Marina Del Mar, California and meet with Dr. Mark Scholz. He doesn’t take insurance and charges about $500 for a visit, but he really knows his stuff. If you go on YouTube, you can look at PCRI conferences and hear him give talks on treatments for prostate cancer

Your father has a tough case and you really need to address it immediately. PSA numbers are usually counted for how long they take to double so your father‘s jump Is quite excessive.