Hi Phil,
My husband was first diagnosed in 2005 after a local biopsy, and testing seemed to show that the cancer had not spread outside the prostate capsule, so he was treated locally with only brachytherapy and external beam radiation to his pelvic area. All seemed well for six years, when a sharply rising PSA alerted us to a recurrence. That is when my husband referred himself to Mayo and Dr Kwon. We don't know if the cancer was already metastatic in 2005, or whether it became so sometime in the next six years. It was explained to us that the prostate cancer sort of seeds the bloodstream with cancer cells, which circulate around until they finally create a metastasis, but we don't know at what point that happened. The treatment protocol at Mayo has been jokingly described to us as "whack a mole," and what follows explains why. Between 2011 and 2016, my husband had several rounds and types of radiation at Mayo, and was on various medications during that time, including bicalutamide and others I can't recall now. In 2016 it became clear that the metastases were coming fast and furious, and that chasing them with spot radiation was no longer controlling them, and that is when docetaxel was prescribed. That kept the cancer quiet for some time, but eventually more rounds and types of radiation were necessary, along with abiraterone and prednisone starting in January 2020, which kept the cancer in remission for over three years until the next recurrence. Finally in January of 2024, my husband began Pluvicto treatments, which lasted until August of 2024. It was only moderately successful. Xtandi was begun in January 2025 but was discontinued after four weeks due to bad side effects, which my husband never had with Zytiga/abiraterone. More radiation at Mayo in March 2025, after which the PSA dropped some but did not became undetectable. Scans in June 2025 didn't show where the active cancer is hiding, so we return in September 2025 for scans and labs and a conversation about what to try next.