Prognosis for Stage 4 Metastatic Prostate Cancer

I hope we can both get some good solid advice quickly. I don't have any underlying issue, so maybe that is in my favor. They said that it has not entered any major organs of the blood morrow yet, so maybe I can stop it before it does. Thanks for your response.

oldfords, my husband is similar to your scenario; diagnosed October 2023 and had to have emergency Lymph Node biopsy because he was so ill. Unfortunately he was positive for metastatic disease in his peritoneal nodes and also soon after in his bones. No prostatectomy. His psa was at 717 at time of the biopsy. He has not been informed of either low or high in the bones, only words used in PSMA Petscan report was "scattered in skeleton" with a few suv values between 2.00-3.00. Was never given a gleason score and we only were told 2 places that had an SUV value and have no idea where else the cancer was seen. Unfortunately it was a regular radiologist that did the PSMA Petscan and not a specialized radiologist oncologist. I have spend many many hours researching and following videos, conferences, blogs, etc to learn whatever we can learn. My husband has "Aphasia" from stroke from 12 years ago so he has difficulty with language and expression. He currently on Xtandi 80mg 2x for 4 months now and as of mid March PSA down to 0.04. Very fatigued but no pain with very sore breast. We have concerns of the toxicity of Xtandi and he has CKD stage IV (also heart issues). Oncologist has not provided any other plans at this time as his words to my husband "not curable but treatable and quality of life is important" . My husband did get one injection of Xgeva but unfortunately his calcium went way down to 7.2 and oncologist nurse told us to speak to Neuphrologist about advise so we jumped on the wagon and added Calcitrate Petites (500 iu Vit D, 400mg Calcium and increased prescribed Calcitriol 0.50mcg) and stopped the Xgeva injections. Oldfords, we totally understadd getting advise from others and also would like feedback. Thinking about adding Docetaxel but our impression is that his oncologist is following the prior years recommendations and just taking an observation stance until the next stage (his oncologist calls his MCSPC and next stage would be MCRPC) but we are not comfortable with waiting and staying on the Xtandi until his cancer gets worst. My understanding is that the new recommendations are to take an earlier aggressive approach in 2024. I had read that Darolutamide is less toxic on the kidneys and the heart. Should we do Docetaxel and localized radiation or just one treatment at a time? Hope we can both get feedback.

Get a comparison of Lu 177 to Radium 223 with OS overall survival statistics

Lutetium 177 is now available to patients outside clinical trials, at least in the U.S. It is marketed as Pluvicto, and deals with metastases on the spine and other bones as well as elsewhere. Many people on Mayo Connect are discussing Pluvicto. If you are in South Dakota, oldfords, you could easily get to Mayo Rochester if there is no one closer to you. Do a search on "Pluvicto" in Mayo Connect and you can read these discussions.

Zofigio https://www.drugs.com/xofigo.html

Read The OS today is far longer before chemo being needed or LU 177 radium

OS Overall survival I hear is 31 months

Thanks for the response. I will look into this and speak with my doctor about R233. At this point I am looking for anything that will offer a little hope.

FIND Xofigio or Radium 223 It will save you and stop the stress Mel

URGENT I am on Zolodex every 12 weeks to reduce testosterone the fertilizer of pc
When cancer went to bones they radiated 1 inch out of L2 lumbar in 2020 Then put me on Xtandi or Enzalutamide which lasted a year keeping my PSA down to 1.7 It rose to 9.8 so takenOFF of Xtandi which fails after a year
They were going to start Chemo docetaxel when I went to PMH Princess Margaret Hospital and said NO
As its only in bones you qualify for Radium 223 or Xofigio which targets only cancer cells in bones and kills them and only the cancer cells No hair loss just a tad tired and occasional pooping One 3 minute injection in vein every 4 weeks for 6 months then another bone scan My local Mississauga hospital does it every Wed for me so no travel to Toronto Its all covered by healthcare I am 79 Had prostate radiated out in 2017 It came back 4 yrs later
They also include a 12 week needle injection of Xgeva that puts calcium from the blood back into the bones I take 600 mg of calcium with D and K pills from pharmacy as well as 2 apple cider vinegar gummies daily
GOOGLE all these names
Stop chemo get immediately on Xofigio. Lu 177 is still clinical trials but its for cancer that has spread outside the bones Radium 223 is for bone only which you have
Find Xofigio support from a oncologist Save yourself I am on 4th injection Feel great.

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I am new here and thanks in advance to anyone reading and commenting. I am 77 years old and just got the news that I have osteoblastic metastatic disease. I guess I am somewhat lucky that it is not in any major organs, (heart, kidneys, liver or others). It also has not reached the bone morrow yet. I am just now being evaluated for treatment. They are looking at a three step approach, Lupron, Darolutamide, and Docetaxel. Has anyone else had this kind of treatment? I live in the Black Hills of South Dakota, so my options are not as great as if I was in a more populated location. Meantime stress and anxiety are trying to eat me alive. Thanks for reading and thanks for this forum.

We’re looking at COVID mutations just like prostate cancer mutations- AGREE 100%.