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Stage 4 Metastatic - what to expect after 6 months?

Prostate Cancer | Last Active: Sep 24 4:04pm | Replies (70)
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Profile picture for doyleoot @doyleoot

I was diagnosed with Advanced Prostate Cancer in May 2025 my PSA was 340. Following 2+5 monthly Firmagon injections, that overlapped with 6 docetaxel infusions given every 3 weeks, my PSA was down to 2.07 on 07 Jan 2026. I was put on Relugolix and Darolutamide a month or so before the doxetaxel finished but on 24 Apr 2026, following a PSMA-Pet scan that lit up showing active tumors, my PSA had gone up to 7.6. The PSA was 44 on 09 Jun 2026. I have an appointment on Monday 22 Jun 2026 with one of the top oncologists in the country. I'm hopeful that there will be follow-on treatment.

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Replies to "I was diagnosed with Advanced Prostate Cancer in May 2025 my PSA was 340. Following 2+5..."
amota | @amota | Jun 19 1:13pm

@doyleoot Hi,
You don't say how old you are. In my opinion, you should consider a surgery if you are younger than 70.
I had my surgery when I was 68; at 70 I would have not done it.

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jim18 | @jim18 | Jun 19 2:25pm

@doyleoot If you have continued on the ADT you may have become castrate resistant. There is a second (different) chemotherapy that can be used; also Pluvicto if that applies to your case. If there are only a few limited spots that lit up may be treated with SBRT. The PET was not good news but there are still treatments available. As you probably know RP not indicated once the cancer has metastasized.

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Jeff Marchi | @jeffmarc | Jun 19 2:27pm

@doyleoot
Hopefully, they can zap those tumors with SBRT radiation. It can bring your PSA down again. I suspect you had a lot of metastasis at one time because you usually have to have a lot in order to have chemo in the beginning.

What country do you live in?

If the metastasis are in spots that are near organs they don’t want to radiate, you can have xofigo if they are totally in the bone. If they are in mixed places then Pluvicto is another option.

Relugolix and Darolutamide are a real good option. They worked well for me and a lot of other people I know. Maybe they can zap those spots and you can get relief for a while.

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