Your husband would be metastastic if the bone scan showed bone mets - that is M1. Adding chemo was tested for patients with four or more bone mets on bone scan. So at the moment there is no guideline recommendation to add chemo when there are no bone mets.
I was on Zoladex, and became resistant to it, Now the Second month on Firmagon as well as Xtandi, oral Chemo, and will start with Radiation soon, my scans indicated a clean bone scan..
There appears to be some missing information, but I can comment on multiple approaches.
A combo approach using some front line treatments such as radiation and ADT might be in order. Your Oncologist should help guide U thru. I suspect that RP would be useless.
For what it is worth, I was NODE positive with a G9, T3B Dx.
That combo, done aggressively, at the beginning of treatment worked for me.
2 years later, I am undetectable.
Of course, no 2 cancers are identical, but attacking the disease ASAP might be beneficial.
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