History: Radical in 2000, GS 4+3, remission until 5 years ago. Oligometastic disease (spine and sacrum) treated with SBRT 2 years ago but later found PCa in lymph node. Had radiation to nodes. PSA zero for 16 months, then aggressive recurrence -- PSADT 39 days. Now one PCa spot on lower sacrum which will get radiated soon. Three weeks ago I started Zytiga + transdermal estrogen (instead of Lupron). I will be on this regimen for at least one year but am leery of stopping because of the aggressiveness of this latest recurrence. I'm tolerating this treatment well, except for major fatigue.
What do you think? If my PSA is undetectable after a year, should I hope for a durable remission without any drugs (except Avodart, perhaps)? One oncologist said I need to stay on treatment for the rest of my life, but I REALLY hate the thought of that. On the other hand, I read that "Snuffy" Myers, whom I respect very much, aims for durable, long-term remissions. But, with my last doubling time of only 39 days, maybe that just isn't in the cards for me.