Widespread Skeletal Metastatic

ok..now you know what you are up against. good news is ADT therapy + a round of chemo should stop spread immediately--- and shutting off testostrone will begin to shrink the tumors wherever they are...in 3 months or so, you can prob have some radiation to further shrink tumors..if you smoke and drink, stop now.. start an exercise regime..start eating healthy..lots of water...Alpha Lipoic Acid once a day with multi vitamin..

many guys have had much worse early prognosis and lived long fun life after...take a deep breath, relax and welcome to the club no one wants to be in..I think you are gonna be around many more years !

( make sure your oncologist communicates with you and get moving with treatment !)

Thank you so much.
I'm the worrying wife 😉 I guess I should have specified that.
Initial diagnosis was at the beginning of January - within 2 weeks they had started him on Reluglulix.
I'm counting on the treatment working wonders, and hope the chemo won't be too rough.

So yes, that's tough. But it's exactly what triplet therapy is designed to manage. 5 years ago, his team might not even have known about that approach, much less offered it to him. Things are improving so fast! Even if a specific treatment buys him only a few extra years on its own, that can be enough to get him to the next new treatment (and so on, and so on). It's not a static situation these days.

If his PSA comes down quickly, then he's in a good place. Even if it doesn't, there are new-ish treatments like Pluvicto, basically injectable radiation therapy that will seek and and bind to all the little metastases.

I wish you the best of luck. Keep being stubborn (both of you). ❤️

A couple of valuable resources:
https://www.scientificamerican.com/article/treating-prostate-cancer-at-any-stage/
https://www.amazon.ca/gp/aw/d/1538726866

@canadaanne
Sorry to read of your husband's challenge. Question: has he ever complained of "aching" or "painful" bones, especially neck (cervical), lower back (lumbar), and thighs (femur)? "Pain" is a hallmark symptom of any cancer that has spread to the bones. I am speaking without knowledge here, but to me, it sounds hopeful that if he didn't complain of bone pain anywhere, perhaps and hopefully, you have caught it in the nick of time, and it will respond well to chemo, like "xahnegrey40" offered.
Prayers for you, your family, and your husband. If you haven't already sought it, perhaps you all would benefit from seeking counsel from a clergyman or a family therapist. You both have and will continue to have thoughts, concerns, and worry that need to be shared and counseled to a better/best understanding and outcome, so you both do not suffer too much or too long with such thoughts. Good luck, and keep us all posted.

@rlpostrp yes, he had some pain before and his dr chalked it up to age and maybe some arthritis!
He went to her several times over about the last year with ‘somethings not right’ and ‘I have pain’. He does have hypothyroidism that’s been well managed and stable. That’s what she focussed on, not looking at anything else.
I think she messed up big time, but hard to know for sure.
He hurt his back in October and they did an X-ray - apparently didn’t show anything of concern. She told him take Tylenol.
Long story short, I took him to Emergency in December and the young Dr asked all the questions, started him on some gabapentin for the nerve pain (back pain radiating down the leg) and ordered a CT. When the CT came back, they ordered another to capture a larger area. That’s how the cancer was discovered.
Was a shock to us.

Hello again -
I failed to ask: Was your husband already under the care of a urologist? Did he have a previous biopsy based on an elevated PSA and concerning digital rectal exam? Or...was the CT following the questionable and unresolved back and bone pain, the first recognition of his prostate cancer? If so, it sounds like he was not diligent in getting his annual PSA over the last several years.
That is how I ended up with my cancer. My Family Practice physician died in a car crash. His practice went dormant for several months before another physician bought the practice. I saw that doctor 3-4 times over about 3 years. Then I suddenly couldn't get anyone to answer the phone. I called many times to schedule an appointment, to include an order for a PSA test. I drove by one time and stopped. I went into the office and it was "door-locked" (not lunch time). I went next door to another doctor's office and asked what is going on with my doctor. They seemed surprised, and said, "he closed his practice quite a while ago." I was dumbfounded, which quickly went to being livid. I could not believe that my physician would close his practice without sending a letter to every patient announcing it, to include a referral to another physician. He just up and left us all. Then...shame on me...I waited a couple of years, because the majority of my care was for my Type II Diabetes. I then thought, OK...I need a new Family Practice or Internist physician. I found one, but being a "new patient", I had to wait 9 months before I could see him. So, it took a total of four years before I had a PSA from my previous one. That was my mistake. That is when my cancer started. I am hopefully going to be OK, but...I had a lot of serious, additional pathology noted in my post-surgical pathology report. My "low-moderate" Gleason Score positive biopsy, was hiding much worse anatomical features of my prostate tumor. So now...I pray daily that I will not have a recurrence within the next five years which happens to 25-50% of patients with my type of cancer. My urologist said that in his practice, he sees about 33% of his patients have a recurrence with my type of cancer. Please let me know the answers to my questions above if you're comfortable answering. There are a lot of unanswered, unusual things that are unknown. Good luck to you and your husband.

Well we will pray for you. There are of people here like jeffmarc to give good advice and so many others that have similar situations

Last January I had the exact results after my PSMA pet scan. They found lesions in exactly the same places that your husband has them.
I was 68 at the time and in really good health. No comorbidities. I responded so well to the hormone therapy alone,Orgovyx and Nubeqa, that the doctor suggested chemo maybe something to reconsider.
I know triple therapy is the gold standard but after my second PMA PET Scan the Cancer had noticeably shrunk and my PSA score went from 136 in January to 0.017 by May.
I know the reasoning in triple therapy is to get it all done upfront, but there can be some long-term negative effects from the chemo. One year in, my PSA has started to go up a little bit, I’m up to 1.25.
Anyway, I agree with the others when they say through the rapid advancements in medical technology, that other treatments will come available to extend our lives. Hoping my chemo decision was a good one.

Best of luck to you and your husband

@rlpostrp I hope your treatments can keep the cancer at bay.

PSA testing is not done here on a routine basis.

@canadaanne, you're right that PSA testing is not routinely done on healthy men with no risk factors. However, there are many nuances to PSA testing recommendations in Canada (and other countries).

Here are a few things to review:
The 2014 Canadian Task Force on Preventive Health Care (CTFPHC) recommends against screening for prostate cancer with the PSA test for men of all ages. However, the greatest benefit from screening appears to be in men aged 55 to 69.
Some associations such as the Canadian Urological Association (CUA) and American Urological Association (AUA) recommend discussing the value of screening through a shared decision-making process starting at age 40 for men with an increased risk of prostate cancer." Read more here:
- Cancer Care Ontario: Prostate Cancer Screening with the ProstateSpecific Antigen (PSA) Test https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CCOPSATestQandA.pdf
Recommendations may vary by province. In general, men can private pay for PSA testing. Men at risk may be covered by provincial health plans.

- Is it time for Canada to revisit its approach to prostate cancer screening? https://www.sciencedirect.com/science/article/pii/S2667193X25001905

Here is further information from Mayo Clinic
- Prostate cancer screening: Should you get screened? https://www.mayoclinic.org/tests-procedures/psa-test/in-depth/prostate-cancer/art-20048087

I post this information for others who may wish to know the guidelines. Pre-cancer is no longer relevant to your and your husband's situation.

I'm sorry to hear that your husband has been diagnosed with prostate cancer at an advanced stage. There are several cancer centres of excellence in Canada. It sounds like he has a good treatment plan in place. May I ask where your husband is being treated?