A quick follow-up on this topic as I realize my input above was brief.

I was 42 when I had prostate cancer and had my prostate removed and 52 when my cancer returned and as mentioned above I am on Eligard/Zytiga and my PSA is at undetectable levels and my doctor does not suggest any other treatments currently. My current treatment could continue to deliver an undetectable PSA for many months, or many years, but eventually my metastatic hormone sensitive prostate cancer (MHSPCa) will become hormone resistant (MHSPCa) and the current treatment will lose its efficacy. I do have a BRCA2 mutation, however, while BRCA2 mutations do predict a shorter time to becoming castrate resistance, that isn’t always the case, and my doctor has several patients who have lengthy times of sensitivity to ADT combinations such as mine.

When that time comes, a variety of therapeutic options will be available. One such option is a PARP inhibitor such as Olaparib with an Androgen receptor signaling inhibitor such as Enzalutamide. The next option will be utilizing a platinum-based chemotherapy regimen such as Docetaxel and Carboplatinum. Last but not least, an option that is only approved by insurance if the other options have been exhausted is theranostic nuclear medicine such as Pluvicto. All of these have side effects of increasing impact.

I hope this helps.