I’m 71 and had a rising psa for several years - when it got to 5 I had a standard prostate biopsy 12 samples - no cancer and an “all clear”. That was august 2022. PSA kept going up so I had a fusion biopsy in January 2023 which revealed 4 samples out of 13 with cancer - 1 was Gleason 7 (4+3) and 3 that were Gleason 8.
Urologist mentioned surgery, HDR Brachytherapy, x ray radiation - recommended radiation. Did not mention Proton radiation as an option. I had a consult with the radiation oncologist and also got a second opinion from proton therapy at UFHPTI In Jax. Decided on proton since they can stop radiation at the tumor area and limit radiation exposure to surrounding tissues. At this point I had a “tidy” cancer confined to the prostate with no metastasis and all clear body bone scan and all clear pelvic scan. Treatment was to be proton radiation for 6 weeks followed by 6 months of ADT.
They did a PET scan of my whole body to confirm no metastasis. That showed I had prostate cancer at 7 lymph nodes distributed on both sides of my prostate and also lower abdomen. Also suspicious spot in my lung.
This was a shock to me and surprise to the docs.
This changed my upcoming treatment to 6 weeks of ADT (Orgovyx plus Zytiga) followed by 8 weeks of proton radiation and staying on both ADT meds for two years.
I’m waiting for the Orgovyx to be approved by my Medicare and AARP United Health Plan medical policy “G”.

It’s been 1 1/2 weeks since the doc told me the PET scan result and said I needed to be on ADT immediately. It’s making me nervous that every week goes by my cancer is growing. Hopefully will hear tomorrow about the approval for Orgovyx so I can start.

I’m trying to brace for two years of ADT and prepare as best I can.
I workout every day with a 30 minute dumbbell routine and back exercises. Also ride bike 5 to 10 miles 2 or 3 times per week.

That’s my situation, any comments or suggestions are welcome.
Thank you all
Tom