If your cancer hasn't metastasised yet, it may never come back. If it has (like mine), consider that I've been on ADT + Apalutamide for nearly 4 years, and castrate resistance hasn't happened yet. 🤞

That won't be the case for everyone, but starting an ADT and an ARSI like Apalutamide or Abieraterone (Zytiga) *at the same time* (instead of one after the other, like they used to do) has rewritten the book on time to castrate resistance with advanced prostate cancer. See, for example, the TITAN, LATITUDE, and STAMPEDE studies.

On top of that, radiating the prostate (if you still have it) and attacking the individual tumours *right at the start* — with external radiation for oligometastatic, or chemotherapy for polymetastatic — has been shown to be far more effective than waiting until the cancer progresses and escalating to one treatment after another. Some oncologists refer to this approach as "doublet therapy" (with radiation) or "triplet therapy" (with chemo).

Best of luck!