@heavyphil Thanks for the input and we are curious too. The eventual failure of ADT when the tumors become castrate resistant, along with side effects of ADT, urge us to question everything prior to swallowing the pills. What if the tumor seeds living in lung tissue all this time have mutated and are not reliant on testosterone? My hubs T has risen pretty significantly since the RARP (from 495 - 800) - is that coincidence, protective intention by the body? Why not test for androgen receptivity prior to ADT? I ask these questions here so those docs trying to care for my hub don’t show me the door!

We should know very soon - Firmagon is now on board and also chemo #1 as of yesterday. It would have been interesting to watch the response to the Firmagon fora bit before chemo, but apparently, the ‘authorizations’ go smoother with the whole plan, don’t ya know. Chemo is docetaxel+ carboplatin, which is not standard for mHSPCa - due to ‘high volume’ designation because Mets is in a visceral organ - lung only. Unique presentation = unique response? Suspected transformation already as Hans suggested in this thread?