My husband has stage 4 metastatic prostate cancer

I was stage 4 right from the get go, as I was starting treatment with chemo, I asked the nurse why I wasn't getting my prostate removed, she said they could of before it had spread. I just figure it's too late for that now. best to you.

Probably not. You would only remove cancer from the one spot and still have to treat the rest of it. The surgery itself has its issues and side effects. I know that personally.

Yes, same here. Once the cancer has escaped the prostate, it's too late to close the barn door (so to speak) with a radical prostatectomy.

In any case, even with non-metastatic PC, radiating the prostate has the same overall survival as temoving it (though I would still have gone with removal if we'd caught it earlier).

Do the radiation then get on zol9dex and only layer enzalutamide

On mine they radiated the prostate put me on lupron an aberraton (spelling not right,)then chemo good luck Dave

Now that his prostate cancer has escaped the prostate, it is too late for a prostatectomy. Radiation and medication are the ways to attack the cancer, perhaps along with chemotherapy at some point. Good luck to you both.

I am 3.4 years in on this stage 4 prostate cancer journey. I remember those "Just Remove It Days" well. Once the cancer leaves the prostate radiation and medications do a better job at controlling the cancer than surgery. 20 Years ago surgery was the best option, now it's not. Radiation technology advancement along with medications advancements have changed prostate cancer treatments for the better. At this point find an oncologist with a communications style that works for you, one you like works best.

Thank you for being there for your husband.

Well, yes an no. I don't like statements from my medical team that are "all or none" choices. It indicates to me that they are not current in their practice or worse, biased based on their clinical speciality.

There are some who advocate for removing the prostate in this situation - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449684/ while combining systemic therapy such as ADT or chemotherapy and potentially whole pelvic lymph node radiation with boosts and wider margins around the identified sites. The idea behind removing the prostate is to eliminate the mother ship though with he PLNs identified, maybe not. Yes, the surgery has side effects, well known. Those will vary based on in part the skill of the surgeon, whether or not it is nerve sparing....I had mine in March 2014, no incontinence, nerve sparing, I was able to and still have the ability to gain and maintain erections though with assistance, daily Cialis and greater stimulation required. Yes, the ejaculation is gone, some miss it others don't. Sex is different after surgery, no doubt, but for those who are fortunate to have nerve sparing surgery, there is a vast array of possibilities in penile rehab therapy. A couple can also choose to "redefine" sex other than just penetrative intercourse.

There is also the option to not remove the prostate and do doublet or triplet therapy combining radiation and systemic therapy to eradicate the PCa cells in all identified locations as well as the micro-metastatic disease too small to be seen by even the most sensitive imaging today - https://www.mdanderson.org/newsroom/metastasis-directed-radiation-therapy-plus-hormone-therapy-improves-progression-free-survival-for-men-with-advanced-prostate-cancer.h00-159543690.html#:~:text=Metastasis%2Ddirected%20therapy%20(MDT),which%20is%20continuous%20hormone%20therapy.

So, he has options, try and do some literature searches on the options, have discussions with your medical team (urologist, radiologist, oncologist) and with their input, decide what is best for you two.

Kevin

Thankyou All for your insight and information. As you all know getting this news is heart breaking and overwhelming! I felt the need to gather information and opinions from men going through this! My husband and I appreciate you all! Best of luck in this battle!

Sounds like my diagnosis. I was leaning towards radiation treatment and the little dot on my pelvis solidified the radiation and hormone treatment.