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Treatment for Prostate Cancer Metastasized to Bones

Prostate Cancer | Last Active: Sep 24 7:12pm | Replies (171)

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I'm sorry for your news.

The big question is how many metastases they discovered. If there are just a few, then you're oligometastatic, and they may choose to treat the individual metastases with radiation; if they're widespread, they may choose chemo up front to knock it back a bit. It's also increasingly common to give a "curative" dose of radiation to the prostate, even at stage 4, because studies have shown a significant survival benefit (that's a big change in thinking from 10 years ago).

They'll likely also put you on hormone therapy, including an ADT like Orgovyx and an ARSI like one of the -lutamides or Abiraterone. If your PSA responds to that, then the cancer is still "castrate-sensitive"; if/when it stops responding, your cancer has become "castrate-resistant", and they may suggest other treatments like additional chemo or Pluvicto.

Don't be discouraged. I was 56 when I was diagnosed with de-novo stage 4 prostate cancer metastasised to my spine, and I was certain my life was drawing to a close. I'm 60 now, with no evidence of disease (that doesn't mean I'm "cured", but modern treatments can put many of us in deep functional remission almost indefinitely).

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Replies to "I'm sorry for your news. The big question is how many metastases they discovered. If there..."

Hi,
Did you have Chemo and if so how long ago did you have it? That's great you are doing okay after 14 years. That's really great.
My husband's PSA is up to 60 now. He's on Apalutamide and Eligard shot every 4 months, but the hormone therapy is not working as well anymore. He was diagnosed with Stage 4 metasasized to bones and lymph gland and his PSA was 418. They started him on hormone therapy and it dropped in 6 months to 2.6, but 1 1/2 years ago, it's been going up and up.
We just saw the oncologist last week, and they will do another bone scan and CT scan and them maybe Chemo in Sept., although we are both scared of Chemo and what will this do?
Did you have Chemo?

So happy to hear you have no evidence of disease. Did you have any genetic testing done on your prostate tumor (usually they use tissue from your biopsy)?