One of the major problems with ADT is that you can become castrate resistance within 18 to 30 months If just on ADT. It took me 2 1/2 years To become castrate resistant on ADT alone. Median survival after you become castrate resistant is two years. I’ve been castrate resistance for six years, but then my Gleeson score was only 4+3. The fact is the median means that as many people died less than two years as more than two years, Not a risk that’s nice to consider.

An ARPI can keep your cancer at bay for a lot longer and safer than ADT alone. Xtandi (Enzalutamide) can be hard for some people to live with. Much better and just as effective is Nubeqa (Darolutamide). It has many few side effects and doesn’t pass the blood brain barrier so it doesn’t cause the brain fog that Xtandi can. Ask your doctor if you can have that instead. I’ve been on Nubeqa For two years and have had no side effects that I can attribute to that drug.

Your biopsy shows you have a serious problem with it spreading beyond the prostate. In those cases, it is highly recommended to be on an ARPI as well as ADT. That can extend your overall survival.