PSMA PET CT question

Hey!
My husband (55) got diagnosed a year ago with a high PSA (285!) then CT scan showed it outside prostate and biopsy had mostly 8,9s gleason scores a few 7s.
Urologist referrred to oncologist and he scheduled the PSMA pet scan and to our horror, my husband lit up like a Christmas tree! it was everywhere!! the only symptom was frequent peeing and a bit of ED..... this all triggered ADT (monthly Firmagon injections and daily Zytiga pills with prednisone) and he did chemo over the summer! Then after the chemo he had a second PSMA scan and it was MUCH better! a few spots still there but he's doing "great" overall!
I'd say go for the scan!!

Thank you for this and wishing your husband continued upward trajectory in his status.

@beaquilter
I was Dx'd at age 53 with G9 p3TbN1M0 after my RP. Have since completed 39 RT and 2 years ADT + zytiga. 6 months off treatment and T returned to normal levels. Restarted ADT after BCR and eventually added Xtandi. That eventually failed July 2025. I'm now in a clinical trial for a newer Lu177 radiogland which is going pretty well.
Anyway, make sure the husband stays active and goes to the gym to maintain muscle and Bone density. If I had one exercise I would do farmers carries. Google it It's ideal for BMD.
In addition to playing ice hockey, I ski, play pickleball, hike with a 30lb ruck sack and gravel bike ride. So I do maintain a very active lifestyle.
I'll be turning 60 next week

@mrfluffy he goes to the gym every day, always did and eats pretty perfectly. He mostly does weight lifting and a sometimes the treadmill-I think or warms up with that.
we walk every day together.
So there is a break where maybe we can get our sex life back??
I'm scared of pluvicto. I'm scared of it all.... of losing my husband and what I'll do without him.
we had 3 deaths and a terminal diagnosis within 7 months! (First his parents- they were old, then my mom 2 weeks after his diagnosis) so...
It's been a rough 2 years to say the least!

@beaquilter
I see this is all very new to you and your husband. You'll adjust . One big positive that came out of this diagnosis for me was not waiting to do things. I do the stuff I thought I would do in retirement now.
As for pluvicto, no need to be scared. It's easier on the body than chemo. There are many different radiogland treatments in the pipeline and many will be better than what is available today.

@jcf58 A three year time frame review of Tulsa Pro is very short as a critique on recurrence issues with it. What I think really put me off on focal treatments was the quote posted below by @Jeff Marchi from this thread https://connect.mayoclinic.org/discussion/cryotherapy/

As you know, cryotherapy is focal therapy. Here’s an opinion by one well respected physician.
At the 11/1/2025 PCRI conference the following was said by Matthew R. Cooperberg, MD, MPH
What about focal therapy?
* The energy modality matters much less than the accuracy of the imaging - which is not there yet.
* Overall focal therapy is associated with minor side effects, but high rates of recurrence both in- and out-of-field.
* Focal therapy is not really a replacement for surgery or radiation; it is better considered an adjunct to active surveillance

@wwsmith
The reason he mentioned about accuracy of the imaging is exactly why I did Tulsa Pro. I was monitored in a real time in an MRI ensuring margins and temperature were accurate. My radiologist told me he’s done 20 years of ablations (for other cancers) in his career and nothing gave him the level of precision that Tulsa Pro does.