@drcopp Adrenocarcinoma responds better to treatment than (much rarer) squamous/small-cell prostate cancer, and PSA is a reliable marker for it, so that's "good" news, as far as it goes.

There are two types of hormone therapy:

Androgen-deprivation therapy (ADT), which severely restricts the production of testosterone. Examples: Lupron, Firmagon, Orgovyx. (Testosterone is the main "on" switch for prostate cancer cells to start multiplying.)

Androgen-reception signalling inhibitors (ARSI), which prevent the cancer cells from "seeing" any testosterone that does slip through. Examples: Erleada, Xtandi, Nubeqa, or the older Zytiga.

It used to be that for metastatic prostate cancer, they held the ARSI back until the ADT stopped working, but after a series of studies showed huge improvements in overall survival and time to castrate-resistance from starting ARSI at the beginning of treatment, it's becoming more common to offer both right at the start now.

@drcopp
I suppose you mean your Gleason score is a six.

If your Gleason score is only a six, then prostate cancer treatment is not normally recommended. If your PSA has been rising at a good rate, then an MRI can show whether or not there is any tumor inside your prostate. That’s the best way to find out what’s going on.

You can also get a PSE test, which will tell you or whether or not there is actually prostate cancer in your system. If it shows there is then you need to get a biopsy.

If someone has given hormone treatment, they are given ADT. The most common ADT drugs are Lupron and Orgovyx. ADT also includes Firmagon,, Eligard, Prostap, Camcevi, Lucrin, Zoladex, Trelstar, Pamorelin, and Decapeptyl They can cause numerous side effects. Actually due to a lack of testosterone.