Diagnosed with stage 4 PC about 3 years ago. Bone mets and one lymph node. PSA 81 Gleason 7. Began Lupron/Xgeva treatment. After a year, Mets undetectable and PSA ~2. Added Casodex and PSA quickly dropped to .05. At 2 years PSA started doubling every 3 months. Also developed ONJ due to prolonged Xgeva use. Root canal gave some pain relief, but chewing impossible. Stopped Xgeva about 6 months ago and jaw started to heal. PSA continued to double and switched from Casodex to Xtandi. Almost immediately ONJ returned as well as persistent headaches. Along the way had open heart surgery for valve replacement (~1 year ago). I have no energy and have to take two antidepressants. While PSA has been doubling, it is still low (last test was 0.50). Would appreciate any suggestions.