Metastatic Prostate Cancer: Where do I go from here?

I have a family history of prostate cancer (grandfather, father, brother) so I have been very diligent in getting my PSA checked annually. Last check, PSA had more than doubled from 1.4 to 3.6 in a year. Still in normal range for a 71 year old. Because of my family history my urologist recommended an MRI on 12/29 which showed PI-RADS Category 5 with several lesions in the bones of my pelvis. Next, a CAT Scan which showed no evidence of cancer (?), next a bone scan that confirmed the MRI results, next a biopsy that resulted in a Gleason score of 8 and Stage 4 cancer, finally a PET scan that confirmed cancer in prostate, 3 locations on my pelvic bones and sacrum, one lymph node, and nowhere else. Started on Casodex immediately after MRI, scheduled to start Lupron next week, started Zytiga 3 days ago. Radiology oncologist has scheduled 5 weeks of radiation to my prostate starting in April followed by local radiation of the lesions and lymph node after the ADT has taken effect. The PET scan indicated clear targets for radiation and both my oncologist and radiology oncologist are optimistic. Should I be?

5 years since radiation 40 timers PC mediatized to my L2 lumbar which I had radiated. 2 years since that its showing up in T 10 L1 and hip This is all regional I thought or at least local
My oncologists says I have stage 4 castrater resistant now
Is that so

I have been back on Zolodex PSA 6 and testosterone zero

he want me on Enzalutamide in Jan 23rd

Approximately 80 percent to 85 percent of all prostate cancers are detected in the local or regional stages, which represent stages I, II and III. Many men diagnosed and treated at the local or regional stages will be disease-free after five years. So nothing to worry much about it stay positive always.

https://www.ottawahospital.on.ca/en/xofigo-radium-223-therapy/

They say its held for those who have tried everything else More palliative?? ??

Consider discussing Lu 177 – Pluvicto with your oncologist.

Similar Stage 4 castrate sensitive in L2 was radiated and back on Zolodex Then 2 years later PSA 1.2 goes to 6.6 New PET and CT scans show slight uptake in left hip socket and T10 T 11 and L1 or L2 not sure as I have 6 Lumbar Si I nay be now castrate resistive metastatic pc.

In Jan plan is Enzalutamide to be added 4 pills a day 13K for 90 covered by government health care over 65 I am 78 with 6 years since 40 radiations on prostate

Pray Never a cure only control they say

I appreciate your comments. And I appreciate reading your journey. From reading the comments in this thread, I see a wide range of pills that successfully treat cancer to contain it. All are very expensive and I am beginning to think prescribed to contain-not cure. Sadly saying this. I would keep on the path, however, as containment seems to allow us to have a good quality of life.

I am 82 and cancer recurred a little over a year ago. Have both Urologist and Oncologist treating me. Psa had a quick rise from >0.0 to 20.8. Urologist wanted a PSMA PET scan and prostate biopsy. Scan showed possible contrast rise in lower right rips. Possible cancer metastasized but not sure. He scheduled another scan with same results and psa continued to rise. Called in Oncologist and not sure if cancer has metastasized. They scheduled CT's with IV contrast to chest and abdomen. Abdomen clear but chest showed what us believed metastasized cancer on lower right ribs 7 and 9. Oncologist wants to start hormone therapy of Cadodex for a month then Lupron (6 mos) injection. Started Casodex and shifted Cancer Centers to be closer to home. New Oncologist changed Casodex to Apalutamide daily and Eligard. Insurance would not cover Apalutamide only Xtranida (backorder). Then after 2 PSMA PET and 2 CT scans Urologist wants another PSMA PET scan. Where I stand niw is on daily Casodex, Eligard injection (6mos) injection on 9 Jan, and 3rd PSMA PET scan on 10 January. Then won't see both Urologist and Oncologist last week in January. Psa has gone from 20.8 on 9 November to 2.7 on 13 December. That is where I stand. So far feeling great with no pain. Seems that everyone I communicate with had different treatments fir advanced/recurred Cancer. Hope you are doing well.

My radiation specialist wants to radiate my L2 again to continue to knock out the cancer 1 inch not just for pain relief which I have little

I'm 78 with 3 month injections of Zolodex Putting me on 4 chemo pills a day of Enzalutamide. How do we differ?