I have read hundreds of case histories of PCa because the best predictor of the future is to study the past. The usual scenario...BCR after primary therapy or mPCa at diagnosis. At this point you can do a PSMA scan or Choline 11 scan to locate the hot spots. If Oligo ( 5 or fewer) go after the PCa again with radiation, which almost always fails because radiation selects for the most aggressive 5% of cancer cells which survive and go on to form tumors....or scans reveal more than 5 hot spots so Lupron is started with or without taxotere and the PSA goes <.1. But, lupron fails after 3 cycles and now you have mCRPC. Time for Zytiga and Xtandi and both fail between 6-18 months. The DT keeps getting shorter so time for another dose of Chemo. The Chemo knocks the PSA down but just like with radiation selects for the 5% super aggressive cancer cells and stem cells which survive and go on to form a tumor which is resistant to all therapy. This leads to something far worse than mCRPC that only has one benefit...you no longer have that damn urge to go after the Ladies with LFIDS (little friend is dead syndrome). This condition is called SCDS (stone cold dead syndrome).
But check this out there may be another way...LIM (less is more) which also in 75% of the cases preserves muscle mass, cardio vascular health, no brain fog, and sexual fuction...what is this miracle...IADT with only 50mg of Casodex. Check this dude out...18 years and still ticking.