Ex's PSA now 99, up from 32, 5 weeks ago. Started xtandi 4 months ago when PSA was 30. He doesn't want to ever do chemo again and is very resistant to Zytiga because of the concurrent prednisone requirement. Onc wants to try Xofigo and Zytiga now. He received his 3month lupron shot but is considering ceasing all other treatments. I'm not sure how to guide him. He is 45 years old and we have two children under 8 years old. He was diagnosed 1 year ago with a very aggressive cancer, PSA over 2700. We knew treatment failure was a possibility but our family is struggling. Right now, his quality of life is more important than quantity. Pain is intense, but well controlled with narcotics.