Starting Stage 4 treatment

Hi Dan,
sorry about your diagnosis. This is a very knowledgeable and supportive group and you did good in coming here. It appears your biopsy findings are inconclusive, so there is a high chance of your cancer (if it is cancer) being low grade. Has your doctor said your lymp nodes are cancerous? and you are at stage 4? Harmone therapy is definitely a starting point to arrest the cancer while you decide on further treatment. There are experienced members on this forum who will answer your questions shortly in more detail. You will find out if surgery is a viable option for you and also about the various types of Radiation available for your condition.

Hi, Dan. I'm sorry for your news. In 2021 at age 56, I was also diagnosed with de-novo stage 4 prostate cancer (metastasized to my spine). It's a huge shock that you're going through right now. My oncologist told me that about 1 in 20 prostate cancer cases are aggressive and fast-moving like this, but that they're more common in people of African or Caribbean ancestry (which I'm not).

The good news is that they're not even sure yours is advanced cancer yet, and even if it is, there are very effective treatments for managing it now. Initially after diagnosis, I thought that my remaining years would be very short, but I'm at 4 years now, still in full practical remission, and cautiously looking forward to many, many more years and hopefully decades.

You'll have to work through a lot of feelings and get used to new treatments and side-effects, but don't be afraid to hope. It's a very reasonable thing to do these days with all the new break-throughs. Here's some more information in an article from last year about how much our prospects have improved recently.
https://www.scientificamerican.com/article/treating-prostate-cancer-at-any-stage/

you must find good oncologist :
start hormone therapy- . then after 90 days, you will begin some kind of radiation...it is possible you might need a round of chemo as well. But you must act now- this is not a wait and see cancer situation. Usually, the cancer stops growing with the ADT therapy..and your PSA will drop dramatically...then radiation will begin to eradicate the cancer left.

But you must get oncologist and get started on the therapy...good luck.. you are at the right place as many many guys on this site have faced similar diagnosis and are still around yrs later !

Can you share more information about your biopsy results?
Gleason Score?
Decipher test results?

Can you share where you are being treated as others in this group may have specific doctor recommendations?

The details help people in this group to provide more specific details on the present recommended therapies and more specifically, the combination therapies that may be recommended.

Hi and welcome. Sorry you had to find your way here. I have a similar back story. Full diagnosis in profile (just click on @mjp0512 above) but suffices to say, the stage 4 realization was a shock. My treatment plan from day 1 was ADT/ARSI (Orgovyx/Nubeqa) followed 4 months later by IMRT to prostate. There is some bone lesion involvement that will be zapped later. After much research, I found my treatment plan to be directly in line with recognized standard of care. Wishing you the best.

As others have said, you have not supplied enough information. What was your Gleason score when they did the biopsy? Was there anything else found in the biopsy that wasn’t Normal.

The fact that you have lymph nodes showing they have cancer means that it is aggressive, and I could spread anywhere.

Starting hormone therapy would be a good place to start, but you do need to treat the prostate unless there are so many tumors found that it is better to do chemotherapy.

You need to find out more information from your doctors. You are just not being clear on what was really going on..

What matters most is you are starting, that's epically good. Keep it going. Hope is good medicine.

@shalom7777777
I meet this week to discuss treatment It has been diagnosed as cancer in prostate, abdomen and Chest Lymph glands

My medical support is a combination of Summa Health and Cleveland clinic. “Gleason “ rating has not been used in any of the test reports yet. This is the report:
NECK AND CHEST:

There is intense (maximal SUV 19) Pylarify accumulation within mediastinal lymph nodes, largest of which are located within the right paratracheal region. The intensity of uptake is consistent with nodal spread of prostate carcinoma. No tracer avid lymphadenopathy is seen within the head, neck, or axillary regions.

No tracer avid pulmonary nodules are seen.

ABDOMEN AND PELVIS:

There is intense (maximal SUV 13) Pylarify accumulation within the posterior aspect of the prostate to the left of midline, with extension into the left seminal vesicle, consistent with the patient's known prostate carcinoma. The prostate is enlarged on the low-dose CT images. Bulky intensely tracer avid (maximal SUV 25) left iliac and pelvic sidewall lymphadenopathy is consistent with nodal spread of prostate carcinoma. On the low-dose CT images, a small nonobstructive left renal calculus is present.

@dan67 Once prostate cancer has metastased, Gleason score isn't as important. It's mainly a predictor of how likely the cancer is to spread outside your prostate, but in retrospect you already know the answer to that: 100%. 🙁

When I asked my oncologist, he just said "assume Gleason 8 or 9," since it had already metastasised to my spine.