Gleason 7 (4+3, and some 5). I had recurrent oligometastatic PCa after RP and salvage radiation. We zapped the met with SBRT and I’m currently on Lupron and Casodex.
I have a very smart MO at Dana Farber in Boston, but he is “conventional.” He wants to try six months of ADT and see what happens. I asked about Metformin and he said no good evidence. Hmmm. I see him again in June and will ask about Avodart, Proscar, etc.. and also about Zytiga, Xtandi, and others instead of or in combination with current ADT, but I suspect he will waive them off (maybe for good reason - I don't know). I’m also interested in early chemo intervention as that may provide a survival advantage.
I have seen several MOs mentioned here in the last few months – Sartor, Sholz, Amato, Hussein – who seem highly regarded, think outside the box, and may be more aggressive.
Does anyone have recommendations for an MO that would be good for a consultation, perspective, and second opinion? Basically, how do we decide which drugs to use when and in what combinations, how long, intermittent or continuous, etc...?