My oncologist at Mayo clinic Florida is suggesting radium 223 for me as well. My recent PSMA pet scan found several bones, including a rib, and the lower spinal cord infected with the cancer. He is telling me that radium 223 is only affective against cancer that is in the bones, so if you still have lymph nodes with cancer cells or other soft tissue, this drug will not work for them. I am beginning to wonder if I should have chemo first. Please feel free to offer suggestions.