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Stage 4 metastatic prostate cancer: What's the prognosis?

Posted by majed @majed, Apr 24 4:26pm

Hi all
My husband was diagnised with stage 4 metastatic prostate cancer, it has spread to bones and nearby lymph nodes, he is 51 and with other health issues
Whatbis his prognosis please

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majed | @majed | Apr 25 1:20pm
In reply to @northoftheborder "Stage 4 to my spine in 2021 at age 56. I'm still here, still going strong,..." + (show)
@northoftheborder

Stage 4 to my spine in 2021 at age 56. I'm still here, still going strong, and still in full medically-induced remission.

Everyone's experience will be different, but especially if the stage 4 cancer is "oligometastatic" (just a few metastases) and "castrate-sensitive" (responds to hormone therapy), the prognosis could potentially be good, especially if he's getting modern treatments like radiation to his prostate and metastases, and one of the second generation ARSIs (the -lutamides) as part of his hormone therapy. More here:
https://www.scientificamerican.com/article/treating-prostate-cancer-at-any-stage/

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How long will he stay hormobe sensitive?

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northoftheborder | @northoftheborder | Apr 25 4:52pm
In reply to @majed "How long will he stay hormobe sensitive?" + (show)
@majed

How long will he stay hormobe sensitive?

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It's different for everyone, unfortunately. Some people go many years without developing castrate resistance, and some only a few months. As I mentioned earlier, taking a second-generation ARSI (one of the "-lutamides") together with ADT can significantly extend castrate sensitivity for many patients, as it has for me so far.

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northoftheborder | @northoftheborder | Apr 25 4:54pm
In reply to @northoftheborder "It's different for everyone, unfortunately. Some people go many years without developing castrate resistance, and some..." + (show)
@northoftheborder

It's different for everyone, unfortunately. Some people go many years without developing castrate resistance, and some only a few months. As I mentioned earlier, taking a second-generation ARSI (one of the "-lutamides") together with ADT can significantly extend castrate sensitivity for many patients, as it has for me so far.

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They initially told me I'd develop castrate resistance in 18–24 months, because that was still the received wisdom in 2021. Obviously, that time scale was wrong, since it hasn't happened yet in 2025 (thanks in part to Apalutamide, which seems like a game changer).

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gbrickler | @gbrickler | Apr 26 12:19pm
In reply to @jeffmarc "No one can really tell you how long he has. He needs to get treatment, and..." + (show)
@jeffmarc

No one can really tell you how long he has. He needs to get treatment, and it could stop the cancer in its tracks. His Gleason score tells you a lot about how aggressive the cancer is, Find that out from the doctor.

You need to find a good doctor for Either a second opinion or a primary doctor, a Genito Urinary Oncologist, or a center of excellence like Mayo would give you the best chance of your husband having a remission.

Normally he would be considered for triple therapy. ADT plus abiraterone or a lutamide plus Chemo. Health is a major factor however. That’s why it’s so important to see a doctor. They may only want to do some of those things.

They also may want to do radiation on the prostate, the bone metz and the Lymph nodes. Depends on how many spots there are.

They could use Pluvicto early to try and kill everything. There are so many choices.

You could request a Decipher test to see how likely metastasis is to return soon.

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Majed, excellent advice from Jeff. I was diagnosed 2+ years ago stage 4 with skeletal metastasis. Chemo followed by Lupron and Yonsa (abiraterone). Lesions reduced in 6 months, last 3 six month scans have been clean. I will remain on the Lupron and Yonsa indefinitely. A second opinion is a good move (it was my 2nd opinion that made the Dx). Keep or start a good physical exercise program (any exercise will help) as well as a good diet. There are several sources that recommend diet for cancer patients. And importantly a positive outlook, he will beat this. Prayers to you.

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majed | @majed | Apr 30 3:49pm
In reply to @northoftheborder "Stage 4 to my spine in 2021 at age 56. I'm still here, still going strong,..." + (show)
@northoftheborder

Stage 4 to my spine in 2021 at age 56. I'm still here, still going strong, and still in full medically-induced remission.

Everyone's experience will be different, but especially if the stage 4 cancer is "oligometastatic" (just a few metastases) and "castrate-sensitive" (responds to hormone therapy), the prognosis could potentially be good, especially if he's getting modern treatments like radiation to his prostate and metastases, and one of the second generation ARSIs (the -lutamides) as part of his hormone therapy. More here:
https://www.scientificamerican.com/article/treating-prostate-cancer-at-any-stage/

Jump to this post

Thanks for the reply
What treatmebr did yoy get please

Ans now aftsr 4 years, are you able to live normally? Are yoy able to work

God bless you

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