Oncologist Visit Tomorrow - Need advice

Posted by prbutler @prbutler, 4 days ago

Background...I'm 55 with stage 4 metastatic prostate cancer. Diagnosed November 2025 with Gleason 9 and cancer in my prostate, bones, lymph nodes, and a small spot on lung. I've done 6 rounds of Docetaxal and am currently taking Nubeqa and Eligard injections. We also did 28 rounds of radiation on my prostate. I exercise everyday, have changed my diet, and still work full time. My second scan in late March showed significant reductions in tumors and the lung spot was gone. I still struggle with fatigue, hot flashes, and a lot of joint and back pain.

My PSA has dropped from 6000 (12.1.25) to .59 (8.18.26).

Obviously very pleased with my treatment response.

Should I push for another PET Scan?

I have a lot of joint a back pain on a daily basis, including my feet. I also still have on and off pain in my lower abdomen. Thoughts?

I'm going to ask my team about the most recent data on the use of Pluvicto earlier in care.

I'd love to hear anyone's feedback. Other questions I should ask?

Thank you.

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xahnegrey40 | @xahnegrey40 | 4 days ago

I would wait until yr end and asses. Get PSA and PET scan then. You are doing very well. unless something significant occurs ( with regard to your present symptoms-back pain/abdominal pain etc) I dont really see the point in a PET scan. You are getting PSA every 3 months. You will be in ADT of some kind for 2 yrs so relax and keep doing what you are doing.

Jeff Marchi | @jeffmarc | 4 days ago

You’ve had good progress for a very aggressive case. I don’t think there’s much your oncologist can do besides order a PSMA PET scan to see what’s actually going on inside your body. Your PSA could continue to drop, but you never know with aggressive cases. The pain you’re having could be due to metastasis that have not been cleared up. They can zap them with SBRT radiation.

You could ask to see a palliative care doctor to find out why you have pain if the PET scan finds nothing.