To build on what Jeff wrote, here's the sequence that things happened for me:

T: Emergency debulking surgery on the spinal lesion, and biopsy identifying it as stage 4 prostate cancer

T+2 weeks: started on ADT (Firmagon) and ARSI (Erleada).

T+4 weeks: post-op radiation to the surgery site on my spine (20 gy of SBRT over 5 sessions)

T+3 months: PSA reduced from 67 to undetectable (< 0.01)

T+3½ months: home from hospital (in a wheelchair at the time)

T+6 months: full "curative" dose of radiation to my prostate (60 gy of SBRT over 20 sessions); went into last session using a walker rather than a wheelchair, and rang the bell

T+12 months (give or take): oncologist tells me I'm in full remission

T+2½ years: switch from Firmagon injections to Orgovyx pills (big improvement in quality of life)

T+3½ years: PSA is still undetectable; I have about 75% of my old mobility back, and am living a mostly normal life

Everyone's path will be different, but we didn't know how all of this would go when we started out. I made my wishes clear ("I want to fight") and the oncology team listened ("we'll throw the kitchen sink at it"). My care is classified as "palliative" since my cancer is incurable, but Ive been getting so-called "curative" levels of treatment anyway. I kept advocating for my self, taking treatment sooner rather than later whenever I was offered a choice. Some of it was rough, but zero regrets.