I also have BRCA2. I’ve had surgery and salvage radiation And also had a Metastasis zapped on my spine. I’ve been on ADT for over eight years and for the last three years have been on Orgovyx and Nubeqa. You should talk to your doctor about having Nubeqa (Darolutamide) instead of Xtandi (Enzalutamide). It has a lot fewer side effects and works well with chemo. I have had prostate cancer for 16 years and have been undetectable for the last 31 months with that drug combo. If I were in the condition he is in I would definitely be taking a PARP inhibitor. I am holding off because the other drugs are working for me and the PARP inhibitor frequently causes anemia, Something I’m trying to avoid.

KeyTruda has been shown to work well with Prostate cancer patients that have MSI high and TMB-H. He does seem to have that so there is a chance that it may work.

If he has neuroendocrine prostate cancer, it can show up on an FDG PET scan. Regular prostate cancer won’t show up at all on that scan.