I started Darolutamide (Nubeqa) Tuesday (7/1/2025). My Stage 4 Advanced Prostate Cancer diagnosis was 12/2020, PSA 100+, extreme lower back pain, and bed ridden. Triplet therapy first six months, Radiation, Chemo, ADT. Took about 2.5 ADT years for my PSA to go low, in the 1's. PSA Never undetectable levels, but good enough for me not to worry about 24/7. Very livable. PSA Started slow rise over the last year+. Oncologist put me on Pluvicto, PSA kept rising. He took me off Pluvicto after 4 shots (24 weeks) and switched me over the Darolutamide. Really I am in the transition phase of treatment changing, normally takes a few months, 2-3 labs to see if it works. I also start Radiation again today, first radiation consultation today, very comfortable with radiation. Transformation begins for me when my PSA starts a downward trend. 4.7 Years on this path and still grateful and joyful.