Anyone had prostate cancer spread to the lungs?

@tom99

These were the only two nodules that lit up, but there’s some smaller ones that came up on the chest CT scan that we are going to monitor. The same two were actually on a PET scan 20 months earlier, but they doubled in size over the 20 months and then were deemed a problem that had to be dealt with. Fingers crossed for my early November PET scan.

I wish you the very best of luck!

Hi Tom,
My husband has it in both lungs, but nowhere else! Minor suspect nodules found in both lungs September 2025, oncologist thought they wouldn't be prostate cancer because it wasn't elsewhere in the body. Follow up CT scan in January 2026 showed 10 nodules in both lungs, smaller ones had grown and new ones appeared, his PSA had increased rapidly during this time.
He started Orgovyx in March, followed by Abiraterone and Prednisolone 6 weeks later. He's had a much better reaction to this regime with side affects, far fewer and much less intense hot/cold flushes, less muscle aches and tiredness, though he had unexplained bruising in May, which hasn't recurred since (he had very intense reactions to a previous prostap injection with heart and kidney problems and huge weight gain too) . We've just found out that this regime has worked well and some of the nodules have gone and the others have shrunk so it's working well and his PSA is less than 0.1 again. We hope this continues for as long as possible as he has Cribriform prostate cancer which is aggressive and metastisises distantly. It's rare for it to go to the lungs without it being in the spine etc, but he is currently feeling better than he has for years.
He's nearly 68 eating lots of high protein greek yoghurt, cottage cheese, beans, etc and is full of energy again. He's lost the 2 stone he gained on prostap plus an additional 2 stone by diet and is physically able to do physical work again.
Good luck on your journey 🤞

Thanks, Cher60!

You are the only one I've found with metastatic prostate cancer in the lungs only. Apparently this is very rare. Florida11 sounds like it may be lung only metastasis but he didn't say for sure.

I'm glad your husband was able to avoid surgery and that Abiraterone and Prednisone are working for him. It
sounds like Orgovyx was a better ADT for him than Lupron. This is my second round with Lupron (it was part of my first treatment). I did put on 25 pounds with the first round that I haven't been able to get off no matter how hard I work out and what I eat. My oncologist said I may never be able to get this weight off. My goal now is to keep from putting on additional weight!

After his CT scan which showed nodules in both lungs, did they do a lung biopsy to confirm that the nodules were malignant? That's what they did with me and once they confirmed immediately during surgery that the nodules were malignant, the surgeon made the decision to remove the section of my left lung where the worst modules were located. This is a controversial decision and I'm still not certain it was necessary, but the surgeon was supposedly the best thoracic surgeon in the Northwest, so I went with it.

In any event, it sounds like your husband is doing well and I wish him the best of luck going forward.

Tom

@tom99
Hi Tom,

Totally agree about it being very rare to go immediately to the lungs (He had a minor lesion on a single rib on the back 2 years ago but had successful SABR radiotherapy and no recurrence since) these are the only 2 places where his cancer has metastisised to after his prostatectomy in December 2023, we do understand that Cribriform doesn't travel locally but distantly from the prostate, so the rib and lungs fit that description. He has no cancer in the pelvis area or anywhere else.

The oncologist originally though it wouldn't be prostate cancer as its so rare, but was baffled by his ever increasing PSA and no other sites showing. When they jumped from 4 to 10 nodules and doubled in size in 3 months they trialed him on the double hormone therapy to determine if it was prostate or some other lung condition. (his previous CT scans had shown clear lungs). They couldn't take biopsies because the largest of the nodules were now 9mm and the requirement in the UK for biopsy is 10mm, plus they didn't want to risk spreading it by invasive biopsies on smaller than required nodules.

The oncologists agreed that if the post hormone treatment scan revealed good results with both his PSA and nodules then that will prove it is prostate cancer and not something else, as Hormone therapy would have had no effect on general lung cancer, or other lung conditions.

His PSA has dropped from 36.5 to 0.1 as well as a positive result from the nodules either shrinking or disappearing so they are agreed it was prostate cancer in the lungs. It was wonderful news to hear, especially as he is tolerating this drug combination very well. Our friend is also on Lupron and has no issues with it, its been a revelation in how some drugs can react so differently with a persons biological make-up compared to others. We hope these drugs can help keep it at bay for a good while before the cancer becomes resistant to them and keep living life as much as we can.

Good luck to you and I hope your operation has succeeded in ridding you of the cancer, whilst Frank would have been happy to agree to an operation his nodules were spread throughout the lungs from top to bottom so a partial removal wouldn't have been viable for him.

All the very best

Cheryl

Tom et al,
I had a prostatectomy 9/2024 , Gleason 9, etc. A CT scan followed with lung nodules "only", too small to biopsy.
Two months later CT showed small nodule growth and I added Nubeqa to Lupron injections. Nodules "disappeared" in a short time and all scans including PSMA Pet, showed all "clear" status with no further spread as of today...so two years hormone therapy and voila... still undetectable PSA and testosterone, CT clear. Oncologists confirm it was spread distantly from prostate( unusual but not too uncommon) and not simply "lung cancer" given it disappeared with therapy. That would not have happened otherwise.
Caveat: I have consulted with two excellent oncologists who recommended I begin "intermittent therapy" or holiday, beginning 9/18/26, given strong response to therapy over two years. However, at recommendation of one oncologists I then had a "Caris" test for gene/DNA and found I have 100% Pten loss which "opens the gates" for future cancer spread especially with original aggressive cancer diagnosis. Holiday ? Not so sure without some "gate blocking". I am currently taking Nubeqa 300mg twice daily - off label so don't know if it will help except to keep testosterone low. Hot flashes continue and breast enlargement occurs when Nubeqa alone is taken as a monotherapy.
Question: Should I go back on doublet with Orgovyx and Nubeqa because it worked well, stay the course with monthly PSA and scans with or without Nubeqa? One oncologist said if it was him he'd stop "holiday" go back on doublet therapy, other oncologist said do monthly PSA and scan every few months. Let my body recover from hot flashes, fatigue etc.
It's a dilemma due to issues of Cardio and type 2 diabetes because if there's a recurrence of mets I can't take Truqap plus abiraterone and prednisone, new drug triple "regimen" , as of 7/2026, for Pten loss. Side effects would be daunting - comorbidity more possible.
What to do? Recommendations anyone? Sorry for the epistle! Best to you, Tom and others, who may be on this similar journey.
Richard

Thanks all for your great responses. It nice to finally have some responses that can relate to the lung metastasis, although I'm truly sorry for what you're going through.

It sure looks like there have been some treatments that wildly vary from mine. They never did try the drug approach when the cancer went to my lungs, but went straight to surgery. I then went on what was the accepted standard doublet therapy of Abiraterone and Lupron, with Pregnisone thrown in to counteract the side effects from the Abiraterone. So far, after 13 months the remaining nodules are stable or shrinking. I've had virtually no side effects from any of the drugs.

For rwski79, if it were me I'd stick with the double therapy that worked for you until it no longer worked, but of course I'm in no way qualified to give advice. I just tend to stick with what I know has worked...until it doesn't!

I just had a PET scan last week, primarily because my cea count in the blood work was rising, which can potentially indicate stomach cancer. Fortunately, the PET scan did not light up any new cancers. But I'm going to do an endoscopy soon just so they can take a look and be sure. The PET scan also indicated there may be something on one of my vertebra and one of my ribs, even though they didn't light up. So I'll have an MRI in January specifically to check those out. My oncologist doesn't believe there is anything there, but we're doing it as a precaution.

@tom99
Tom, Thanks for your comment to me about continued doublet therapy - I tend to strongly agree - although sure hate the side effects of hot flashes and fatigue, but fear new mets even more. Curious your oncologist is waiting until January for MRI if there are already some "maybes" about the vertabra and ribs. I might push for sooner scans unless there is good reason to wait...such as? Best to you.

@rwski79
Hi Richard,
Have you considered trying different doublet HT, if the side effects are too much on your current combination?
My husband was determined not to go on Lupron again after so many other health issues after just 1 injection. Once in his lungs he tried the daily Orgovyx and Arbiratone/Prednisolone mix which is is very happy with and has barely any side effects this time. He knew there were other doublet mixes to try if these were too difficult too.
It's such a difficult time for you and side effects can be so debilitating.
Good luck with your journey and medication decision 👍

@rwski79 \
Richard, my oncologist believes the growing CEA count is the greater concern, so we're doing the endoscopy first. The areas in the vertebrae and lung are so small he doesn't think it's a problem to wait until January for the mri, which is when I have my next Lupron shot, blood work and medical appointments.

@tom99
Tom, certainly makes sense. After January perhaps ask oncologist if Orgovyx daily hormone pills could replace lupron. There are fewer side effects. Just a suggestion.