Eligard wears off at end of 4 months

I have not been in that situation, but your description is clear to understand. Have you talked with your medical team about double-therapy options including androgen receptor signal inhibitor such as Abiraterone along with the Eligard? I started a double-therapy 13 months ago and my PSA before treatment was 19.8 and six weeks later it was 0.4 and six weeks later it was less than 0.1 and has stayed that way. I am wondering if you could explore this option as your PSA isn't that high and it might help. Keep the faith (and lay off the sugar if you can).

I'll second what @edmond1971 wrote — androgen receptor inhibitors can conflict with lots of other meds, are expensive (if you live somewhere without public coverage and don't have private insurance), and are dangerous with certain other conditions, but if you're able to take them they make a huge difference.

I also have a bone metastasis. I started on Firmagon (classic androgen deprivation therapy) and Erleada (androgen receptor inhibitor) shortly after diagnosis, and my PSA dropped to undetectable in a few weeks and has stayed there for 2 years. I've also had debulking surgery and radiation to the site of the metastasised tumour on my spine and radiation to the prostate itself.

Unless it's the only option because of other medical considerations, putting you on ADT alone when you have advanced prostate cancer is very old school.

(One downside of Erleada — the androgen receptor inhibitor — is that it conflicts with both Paxlovid and Molnupiravir, the two major COVID medications, so you don't have a lot of options if you come down with a serious case.)

Wow! That's good news. In 6 months your PSA, has dropped 19 points! Congratulations! My PSA was a 13 about 2 months ago, and now it's down to 0.3. I'm on a double therapy, a injection of Lupron every 6 months, and a 1000mg of Abiraterone, and 5mg of Prednisone a day. But I do have a question for you, you said (lay of the sugar if you can)?? What does the sugar specifically have do with Prostate Cancer? I've never heard that said. Thanks you.

Lupron and Eligard both elevate blood sugars. That is why is important to stay away from sugar.

I had another PSA done 3 days after 4th Eligard shot and it was down to 2.5 which is about where it has been for almost a year. Tue only possible question I have is I used Quest lab which uses WHO and not sure what standard the VA uses which showed the 4.1 2 weeks before 4 month shot was due. My urologist who spent 90% of the time looking at the computer said no way should be be any difference and ordered a PSMA for January. After that depending on what it finds and what Dr suggests I am going to get a second opinion ?