I started Lupron in April 2017 and my PSA started rising, even though I was on it, in July 2019. That’s the definition of castrate resistant. At that point, my oncologist had me start Biclutamide. It kept my PSA from rising very quickly and in 15 months more I started on Zytiga. It kept my PSA bouncing around between .2 to .7 most of the time for 2.5 years. Stopped it because of the 3rd afib event. Had Metastasis in my spine zapped with 3 SBRT sessions. Went on Darolutamide and switched to Orgovyx. After 21 months on Darolutamide I have been undetectable for the last 19. I am a Gleason 4+3.

So it’s been six years since I became castrate resistant. I have been on ADT over 8 years. The only problems I have are the side effects from ADT. I have another drug I can take after Darolutamide, I have BRCA2 so I can use a PARP inhibitor. This all started in 2010 with an RP.

When will you become castrate resistant?? There’s no way to know, but it almost definitely will happen if you stay on the drugs long enough. There is a Study using apalutamide Along with ADT to see if that can extend the time to castrate resistance.

It is just another step in our prostate cancer journey. Fortunately, people can live decades with the treatments available now. There are new drugs all the time, we are all just waiting for the cure.

At one of the weekly advanced prostate cancer Ancan.org online meetings I went to a couple of months ago, one guy showed up who had started to have his PSA rise 30 years after surgery.. He was a Gleason nine.