Dealing with metastatic prostate cancer and other health issues

Posted by bmjob @bmjob, Jun 15, 2025

My husband (85 years old and loves his quality of life) was diagnosed with metastasized prostate cancer in March 2025: stage 4 and Gleason of 7.
no symptoms of prostate cancer. Had a PSA 6 years ago, which was 3.2. They stopped giving them when you get older.
Recent pSA 32.
After high PSA, they did testing, and the PSMA scan found that the lymph nodes are
Stage 4 in the Pelvis and stomach, not in bones or organs as of now.

So far, no treatment. he is having a hard time thinking about treatment as he has afib, diabetes, and high blood pressure, and just does not feel good
Any comments please.

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turocket | @turocket | Oct 22, 2025

In reply to @rocket102 "Can you please share how to attend the Wednesday zoom meeting?" + (show)

@rocket102 I think you should seriously think about going to MD ANDERSON in Houston and having them look at him like I said in my statement it is the number one cancer hospital in the United States just in case you’ve never heard of it. My sister is the one that put me onto it. Her husband passed away 10 years ago from prostrate cancer, which was caught way too late. He went to MD ANDERSON three times but like I said that was 10 or 15 years ago and they’ve come a long way since then with all kinds of things I am leaving Saturday to go there. Please check it out if you haven’t already God bless you.

rocket102 | @rocket102 | Oct 22, 2025

In reply to @turocket "@rocket102 I think you should seriously think about going to MD ANDERSON in Houston and having..." + (show)

@turocket thank you!

capatov | @capatov | Oct 22, 2025

In reply to @beaquilter "Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in..." + (show)

@beaquilter

Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in good health and only symptom was peeing frequently which we thought was just an enlarged prostate and part of getting older.
PSA in Feb was 300 or around there, that triggered a pelvic CT scan which showed cancer in lymph nodes and outside prostate so stage 4! Then a biopsy and most of the Gleason scores were 8-9! so fast growing aggressive cancer cells!
Then finally a PSMA scan and it showed it all over his body, his lungs, spine, pelvic bone, lymph nodes near lungs and I forget where else, sounds like he lit up like a Christmas tree! (I did suspect the lungs because he's had this very mild ahem cough for YEARS!)
We don't GO to the doctor, he probably went last in 2019! Ever since Covid, we've REALLY NOT wanted to go to the doctors....
Anyways, here we are.
Treatment has been ADT shots and ADT pills, my husband was VERY against being chemically castrated! He works out at the gym daily and really thought it's his manhood, that he'd rather die than being castrated. But after long arguments and talking to different people, he finally agreed to do the ADT hormone shot, Firmagon (which I'm finding out is an OLD shot, but unlike Lupron it doesn't raise testosterone first and then plummets, the Firmagon just lowers it, and with such severe cancer it was the best option) He was supposed to just get the Firmagon once and THEN switch to lupron, because the side effects (anger etc) are not as severe once the testosterone is already lowered, but my husband hasn't switched yet, so we go monthly to get these injections.
Early on, he researched EVERYTHING online and tried supplements and lots of things, resulting in his liver ALT numbers going way up, to the point where he was in liver failure (blood work wise) but felt totally fine and had no symptoms, but he quit everything!
Then after his liver got almost normal he started daily ADT pills (Zytiga) and Prednisone (steroids)
He IS a lot weaker and more tired but he keeps going to the gym almost daily and does stuff around the house and we walk the dog every morning etc.
almost 2 weeks ago he started chemo (Docetaxel) and it's supposed to be 6 rounds 3 weeks apart! (He refused chemo for a while too but finally relented)
I don't know about radiation, they talked about it briefly at our first visit, but I think they'll see later, because it seems radiation is pointless if he's riddled with cancer! but hopefully this triple therapy gets things under control and scans will get better!
It's been tough, but we're hanging in there, he's very conscious of quality vs quantity of life but has also realized that it's not just about him, it's also about me (his wife) and our 4 kids (9-22yrs, 3 still live at home)
Hang in there!

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@beaquilter - If you have not investigated or tried it, I recommend Orgovyx if your MDs make it an ADT option. It is very tolerable and had few, if any side effects on me. I have read some men live normally on one Orgovyx pill a day for over a decade. In any case, most agree the side effects vs. Lupron and other injectables are far less

trchar | @trchar | Oct 23, 2025

In reply to @turocket "I am 81 years old soon to turn 82. I’ve been fighting prostrate cancer now since..." + (show)

@turocket exact same diagnosis for me 2 lymph node mets. On abiraterone and orgovyx. In 2022 I had 34 rounds of proton radiation. It was successful The cancer in the prostate was destroyed according to pet/psma imaging in March 2025 the prostate was considered cold with no cancer in 2025 however, the same pet scan indicated two lymph node metastasis which my doctor started me on zytega and orgovyx , my PSA is now undetectable. I did complete 25 courses of IBRT for the lymph node metastasis.

sagabronwyn | @sagabronwyn | Oct 23, 2025

MD Anderson has some top oncologists but they can be very difficult to deal with. My husband was going to MD Anderson for a different kind of cancer and was ghosted by two of his oncologists, including his primary. Contacts via email and MyChart went unanswered, no matter how many times we wrote. It's been months now that they haven't responded. It's like you're interesting at first as a research subject, but if you don't quite fit what they're looking for in a patient, they'll start ignoring you. Another downside: they'll make appointments for you without contacting you first to see if the appointment fits your schedule. If you need to change the appointment, it can be very difficult to get them to respond to you.

Yes, MD Anderson is a top notch cancer center, and if you can deal with being ignored while you're fretting about your cancer and prognosis, go for it.

rlpostrp | @rlpostrp | Oct 23, 2025

My Dad was a similar situation. He was diagnosed around age 85 or so, possible 88. His PSA was off the charts over 200. He lived to 99 years 10 months "with" prostate cancer, and never had surgery or radiation. His doctor said he wouldn't survive the surgery when my dad was about 95. He just said: "at this age, he has lived a good life, and any interventions will not likely give him any addition years than his body will give him naturally." As the saying goes: "Prostate cancer grows so slowly that you'll likely die of something else years later, but not from prostate cancer. While that is not always true, it was in the case of my dad, my grandfather, and my uncle. Only my uncle had the prostatectomy, and he died ten years later of a massive cluster-bomb stroke. My grandfather lived to age 96 with his prostate cancer, and only got lupron injections over the ~20 years he had prostate cancer.

duberdicus | @duberdicus | Oct 23, 2025

best wishes for a solution

zmarkv | @zmarkv | Oct 24, 2025

In reply to @sagabronwyn "MD Anderson has some top oncologists but they can be very difficult to deal with. My..." + (show)

@sagabronwyn I agree. Mayo is much more responsive, focused on communication and state of the art treatments. I’ve gone to UTSW Dallas (a sister to MD Anderson) and live in Texas but will travel to see the best that I know of.

dan67 | @dan67 | Oct 24, 2025

In reply to @turocket "I am 81 years old soon to turn 82. I’ve been fighting prostrate cancer now since..." + (show)

@turocket God is the best strength. Praying for you as you face this battle.

f25ccapt | @f25ccapt | Oct 27, 2025

My 87 year old husband was diagnosed on his 85th birthday with Stage 4 Gleason 9 prostate cancer. Scan done in 2023 while in hospital showed metastases in bones only, and he started ADT therapy (Lupron injections every 3 months, Zytiga) and cancer responded lowering his PSA from 383 in hospital to 0.06 in June of 2024. He stopped the therapy in 3/2024 hoping for some relief from the hot flashes, but then PSA started going back up in October of 2024 coming in at 18. Changedfrom Zytiga to Nubeqa after testing indicated PSA still rising, and almost immediately began having extreme fatigue and nausea. B12 levels were low (289) so started a B12 supplement at the direction of the oncologist. Had a PMSA Pet Scan done in June of 2025 as PSA continued to rise and was considering trying Pluvicto. The scan indicated still all in bones, so instead of Pluvicto did Xofigo as it was less restrictive after treatments, and targeted bone metastases only. The literature and doctors kept saying that Xofigo was very well tolerated, so at 87 he started the treatments in July 2025. His fatigue, nausea, and loss of appetite started about 3 weeks after the first treatment, and are continuing now (October 2025) after three treatments and his weight has decreased by at least 10 pounds. He stopped the Nubeqa completely because they seemed to make his symptoms even worse. Most recent bone scan done mid October now indicates the bone metastases have increased and are not decreasing as hoped with the Xofigo. Scan also indicated a small spot on his liver which he will be getting an MRI soon to investigate. We will be discussing other options with the regular oncologist within the next two weeks. Just a word of caution to anyone considering Xofigo: literature indicates very little to no side effects, but my husband has declined substantially since we stated these treatments. I spoke with another patient at the radiation oncologist office who is receiving the same treatments and said they did not effect him except for fatigue the first couple days afterwards, but he was also younger and was no longer doing the Lupron injections. It could very well be the treatments are keeping the metastases lower than they would be without treatment, but his quality of life is deteriorating. Median extra time with the Xofigo is supposedly 2- 3 months, but with 6 months of decreased quality of life during the course of treatments, the question is whether it is worth it. Most recent PSA was at 383 and has basically been doubling monthly since January of 2025. He is now having bone pain that he never had before which is another indication the cancer has gotten more aggressive. I will update once we have spoken with the oncologist as to what the next treatment plan may be. Chemotherapy is probably not in the plan as he is having enough trouble with the intravenous radiation, and even the oncologist had said in the beginning he did not recommend chemo at his age. Been researching for any other options, and I’ve seen some information on immunotherapy for cancer, but don’t think there is anything out there like that for prostate cancer. If anyone knows otherwise, I’d like to hear about it. Will update more as we progress in this journey.