I wrote a few weeks back regarding my husband Mike: Gleason 9 with bone mets to right hip, left femur, (possibly) spinal region, and rib area. His MRI scans last month revealed the most serious mets were located in the femur and hip. I questioned the MO about chemo, but he said that spot radiation and prednisone/Zytiga combo would be more effective in regards to both the pain and 'knocking back the cancer.' Last week, Mike completed five separate treatments. This was going to be ten separate sessions, but the RO was able to program the Accuray machine so that he would have more concentrated radiation for just five sessions. Since completing these treatments he has had ongoing fatigue and pain -- he describes it as a 'sunburn on the inside.' Note: he has been taking the prednisone, still on Lupron, and will start the Zytiga tomorrow. However, the news about his appt with the MO earlier today-- I was not able to attend due to work -- was disappointing. His PSA is now 75 which means that it has tripled since this time approximately two months ago. According to different med sources I've researched, a spike in PSA is quite common following radiation therapy, but most of the articles did not specifically mention this spike occurring after the 'spot' radiation that Mike had. Additionally, there was no mention of such an extreme spike in PSA numbers. Can anyone provide some info regarding this issue or speak of their own experience with follow-up radiation? The MO's plan is thus: start on the Zytiga/pred combo, a Zometa infusion and Lupron shot in four weeks, and two months out if things haven't improved, they start chemo. At this point, I'm not depressed, but simply pissed off that things don't seem to be improving.