I have stage 4 PC, Gleason 9 at biopsy last August
I was put on ADT, immediately with an injection of Firmagon and oral Nubeqa. Essentially this reduces your testosterone to almost zero and cancer starts to shrink and die off since it lives off testosterone . I had a PSMA PET scan about 2 weeks later. Cancer had spread to one lymph node and 4 places in my pelvis.
Going on ADT pretty much stops the cancer from further growth, essentially putting it to sleep. Currently my PSA is undetectable from a high of 62 when I was first diagnosed. All of my cancer areas had significantly reduced in size after the first 6 months of ADT treatment. Keep in mind that everyone’s cancer is unique and treatment protocols will vary per individual case.
I was lucky and responded very well to ADT, but some guys don’t. Your docs should also order a genetic test to identify the cancer’s makeup and for the BRCA 2 gene. This helps guide treatment down the road.
Hope this information helps a bit.