Stage 4 Metastatic - what to expect after 6 months

Thank you for your reply.
I'm 74 years old and in reasonable good health.

@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.

@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.

Honestly, as I approach my 5th anniversary with stage 4b prostate cancer this fall, I'm more concerned about things like arthritis and type 2 diabetes. If we're going to live to old age after all, then we need to make sure it's a good one (that's my family doctor's advice).

God bless you is all i have say. I was diagnosed with stage mestatic prostrate cancer.; my psa was 57 I think Urologist started me on nubeqa psa went down to 17. I was encouraged by jeffmarc and others to see a oncologist. Long story short docetaxel chemo tx brought psa to undetectable and lastv pet scan was good. I take eligard injections 1x q 3 months along with nubeqa. I'm so thankful for this support group and you will find out it's very helpful. I only had chemo txs had to be hospitalized for a perforated colon due to diverticulitis and wound with a oscomy bag. I pray all goes well for you as you are really young Loed willing I'll be 73 in November.

Thank you all for responding.
I live in Ireland. I understand that Cabazitaxel itself or in a combination with another chemo may now be used.

@doyleoot
That other chemo is carboplatin. That is used for advanced cases. You must have multiple metastasis still, and that really is a solution if docetaxel didn’t work.

I hope everything works out.

Thank you. There were multiple metastasis on MRI a year ago. After docetaxel that finished in January this year and when viewing the PSMA-Pet scan the oncologist said that the cancer was active in the right prostate and that it had "flicked" the bones. Anyhow on Monday I should know more.

My diagnosis is similar though I am 20 years older. Diagnosed with aggressive prostate cancer in December after HoLEP surgery in November. Gleason score was nine, PSA was 188 and spots showed up in my lymph nodes, bones and lung. Immediately started orgovyx and mainly suffer from hot flashes and fatigue. After two and a half months my PSA was 2.4. They added Abiraterone and started chemotherapy ( Docetaxel) in April. I’m in the middle of 6 treatments 3 weeks apart. Another PSA test a couple of weeks ago was 1.2. Hot flashes and fatigue have continued along with other side effects. I don’t know exactly what happens after the chemo.