Update on my 83 year old best friend and questions

Diagnosed 10/18 /18 with PSA of 940, extensive Mets on bones and lymph nodes . Gleason 7 and 8.

Currently on Lupron every 6 months , Xygeva every 6 weeks.

Initially on firmagon for two months then to Lupron. Tried Zytiga and Prednisone for 6 months .PSA to 16.8 and stopped working.

Waited from 6/21/19 to 8/18/19 to be accepted for study. At this time , PSA rose monthly from 16.8 to 23.4 to 41.5 based on only lupron and xygeva treatment.

Not accepted to study so started 8/18 /19 on Docetaxel with dexamethosome every 3 weeks and completed 6 sessions . Last chemo was December 4, 2019. No more chemo as there was considerable edema on limbs and pink eye. MO suggested Radium 223 for next treatment.

During chemo alkaline phosphatate declined to 82 from a start of 188 before chemo.

PSA declined from 41.5 to 11.7 during chemo .Not much decline but PSA down after every chemo treatment.

WBC normal throughout chemo.

Hemoglobin remained in the 12 ish during chemo .(Normal value is 13 to 18)

Platelet in normal range between 245 to 342 during chemo

Questions-

Last chemo was December 4th . His radiation Oncologist apt is Jan 16th for consultation. I am guessing that by the time he gets his radium 223 it would be close to the end of January which will be almost 2 months since the last treatment( chemo) So for 2 months all he has is lupron and xygeva ( plus dexamethosome for one week) while waiting for radium 223.

Won’t his PSA and cancer increase due to no treatment other than lupron and xygeva?

Or does the chemo still have some effect after the 6 treatment?

Original plan was to complete either 6 or 10 chemo treatments .

I have read about getting genetic testing fromFoundation one . Could someone give me the correct website for this?

Also , what other treatments does he have left since zytiga doesn’t work for him after 6 months.?

Thanks all for helping.

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I would not be concerned about a PSA rise between when he stops chemotherapy and starts Radium 223. At this point, I'd be relying more on imaging than PSA to determine if there is progression. Sounds like he has had an really excellent response to chemotherapy so far. The effects of that could continue for a while, you can't predict that. You can only deal with what is going right now, so I would recommend trying to your focus on that. It will help the anxiety that I'm sure you are feeling. We all have to deal with this. Right now he's responded well to treatment so that's great. Having molecular testing now is a great idea to see if he also has treatable variants.

Here's the website:

startwithstepone.com/?c3api...

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Thank you for reply and the link . I shared this with him.