Hi @mjp0512 ,

So sorry to hear about your situation. I am a layman, so this info is only my opinion based on what I have learned through my own case and research.

From your PSMA PET scan results it looks like you have more metastases than would put you in the oligometastatic category, which is typically 1 - 5 metastases. You would not be a candidate for surgery. Your metastases are both regional (pelvic) and distant (chest). You are probably a candidate for radiation plus triplet drug therapy, to start with. I believe you should seek an appointment, if possible, with a top notch genitourinary medical oncologist at a center of excellence to review your PET scan findings and medical history and guide your course of treatment.

Triplet drug therapy, to start with, might be Orgovyx + Abiraterone with Prednisone + Docetaxel.

The folks who moderate the Ancan.org weekly Zoom meeting for high risk / recurrent/ advanced prostate cancer patients may be a good source of information for you if you are willing to share your case. This gives you the opportunity to discuss your situation in real time. The next meeting is Tuesday, 6/10, at 5 pm Central time. Please join 10 minutes before the meeting to let them know you you would like to share your case. Here is the link to join the meeting:
https://www.gotomeet.me/AnswerCancer
Their website is ancan.org.

Best of luck to you!