Prostate cancer that has spread to several lymph nodes and bones

I was started on nubeqa orally and then eligard shots I decided to see an oncologist and now I'm taking docetaxel infusion every 3 was. Every dr is different but a good person to talk to on here is jeffmarc he is very helpful 🙏

Probably a triplet therapy of ADT, chemo, and one medication like abiraterone, enzalutimide, darolutamide, etc.
Maybe even a radiogland like Lutitiem 177. Were your mets found via PSMA pet scan? That would find much more than conventional imaging ct/bone scans.

Sorry you have to take this journey. More info would be helpful. Do you still have your prostate would be a major distinction. What was your Gleason score and are there any other factors determining aggressiveness would be another. I assume you've had a PSMA PET since you know it has metastasized. Any genetic testing?

I can say in my case, surgery was not an option. I was immediately started on ADT/ARSI (Orgovyx/Nubeqa) and will begin IMRT to the prostate in a couple of weeks. I'm a Gleason 9 (5+4) with lymph mets in pelvis, abdomen, and chest cavity along with spinal bone mets. No mention of chemo yet other than being possible in the future. Each case and each Dr is different so your path may be different as well.

If you have five or less metastasis, then they can use SBRT radiation to zap them, And they would give you doublet therapy,. If you have more than 5 you usually have triplet therapy, which involves ADT, And ARSI (Zytiga or a lutamide) And chemotherapy or Pluvicto.

When there are more than five metastasis, there’s no treatment other than chemotherapy or Pluvicto, which can treat the whole body and hopefully greatly reduce the number of metastasis, And in some cases reduce them completely. I do know one person that had more than five metastasis zapped with SBRT, It required multiple sessions, that is unusual.

Here is some more information.

Not sure where you are located but find the best cancer facility you can find and also get a second opinion. If you have access to the Mayo Clinic, Md Andeson or Sloan Kettering go to them for either your care or a second opinion. You only have one life and fight it with every tool you have. There are real bozos out there, find the experts.
The medical group I've been going to for basic medical care the last few years (pre cancer) were buffoons. The doctor who took my biopsy said he never saw anything like that before. If that isn't a buzz kill, not sure what is.
Good luck and do whatever you can, and leave no stone unturned.

"The doctor who took my biopsy said he never saw anything like that before."

Had the same thing happen with somatic testing. Doc said, "I've never seen that combination of mutations before."

Me, "Well then you're not the guy I should be talking to, are you? How about you find me somebody that has seen it."

He did.

Yes it was a psma prt scan. No in any vital organs yet. Thank for the reply

I saw a video with Dr Michael Steinberg of UCLA recently who said follow up SBRT can be used now on up to 12 metastatic sites vs. 5-6. Might be worth checking out the latest on this technique?

My lesion score was eight and yes sir I have exactly the same locations as you do except I have mets on the ribs also my PSA was 164 82 days ago. It is now 174 i have had no treatment yet I am waiting to see it oncologist I haven’t seen one yet. It hasn’t been found in any major organs and thank you for your reply I can’t really go to a major center due to my insurance so I’m trying to research as much as I can before treatment

Thank you for the reply I am stuck with local oncologist I haven’t seen him yet due to my insurance I’m on an HMO and they only contract through three oncologist here in town hopefully I can talk them into referring me to USC in Los Angeles I’m only two hours away