Maybe because of age? Or if the docs think it’s way too advanced to make a difference? I think it is the case that sometimes the prostate isn’t treated.

❝Why would one not treat the prostate? I’d assume it would be a continuous source of further metastases.❞

I know, it seems obvious. But in the old days (and I mean only 5–10 years ago), as soon as your cancer had metastasised they often assumed you were dying and switched into full palliative-care mode, where they tried to avoid any "pointless" interventions.

Fortunately for us, the medical community is starting to look at metastatic prostate cancer as a chronic disease that can (often) be managed long-term, instead of a terminal disease. Unfortunately, the memo hasn't reached all the practitioners yet, and it seems every few weeks we get a new forum member with a message like "My doctors found a metastasis and told me I have only a few years to live." Sometimes that still will turn out to be true, but not nearly so often as it used to. It's OK to hope now, and it's definitely OK to fight back against stage-4 prostate cancer.