It’s the type of thing where they got off the drugs and their PSA did not rise real fast after nine months or a year they would go back on and then as long as things stayed stable they would come back off again. That’s when the problems started occurring. Didn’t require much PSA rise in order to have the metastasis start to grow?

This doesn’t happen to everybody, but some people end up with pretty serious cases after a couple of suspensions.

There is a study that shows that even staying on ADT and staying undetectable you can have metastasis start to grow. That’s one of the reasons that my oncologist wants to do a CT scan to compare against the previous ones because the PSMA PET scan doesn’t work very well if you have an undetectable PSA.

This is from the below link

The serum prostate-specific antigen (PSA) level after definitive treatment for prostate cancer (PC) is a powerful predictor of outcome. Occasionally, PC progression can occur despite low or undetectable PSA levels. The authors report on the clinical and pathologic characteristics of patients who experienced PC progression with undetectable or low PSA levels.
https://pubmed.ncbi.nlm.nih.gov/17171704/#:~:text=Thirty%2Done%20patients%20(67%25),atypical%20histologic%20variants%20are%20present.
If you do a search like the following you will find more confirmation of this problem

“Study that showed that prostate cancer metastasis can still occur while undetectable”