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← Return to Starting Stage 4 treatment
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@northoftheborder thanks for your clarification, both descriptions are what my doctor told me when I asked about “Gleason “ today. It’s not in my bones yet but it is in my abdomen and chest area lymph glands. It’s looking like the cancer is abnormal and may be why it was not recognized earlier. Innerductal aggressive cancer. Hormone therapy begins next week, I am happy that the medical team is becoming urgent and appointments are flowing. They are also very open to clinical trials being considered.
Replies to "@northoftheborder thanks for your clarification, both descriptions are what my doctor told me when I asked..."
@dan67 Your next big milestone will be finding out whether your cancer is "castrate-sensitive" or "castrate-resistant".
2–3 months after you start hormone therapy, your PSA should start falling, until (ideally) it becomes undetectable. If that happens, great! You're in practical remission.
If it doesn't happen, don't despair: in 2025, there are many good treatment options, even when the cancer is castrate-resistant.
Best of luck!
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@dan67 My cancer went *only* to my bones — there's never been any evidence of local spread, lymph nodes, etc. Prostate cancer can be weird.
In any case, there's no reason to assume that yours will continue to progress, at least not for a long time (if ever), given modern treatment. The most common treatments in your situation would be
- ADT (which you're going to be getting)
- an ARSI, like one of the -lutamides (which blocks the testosterone signal at the cancer end)
- radiation to your prostate
- radiation to the individual metastases (if there are few of them); or
- chemo or Pluvicto (if there are many metastases)
The important thing now is to tell your care team very directly and clearly that you want to fight hard and are willing to tolerate some rough side-effects (if that's how you feel) — it makes them more comfortable knowing your preferences, so they're less likely to hesitate over decisions.
In my case, it's one of the main reasons they "threw the kitchen sink" at my oligometastatic cancer in 2021 (their words), which has kept me in remission ever since.