The general thought is if ADT (Eligard) response to castrate resistance is very short, go to chemo next vs. second-line ADT (Zytiga, Xtandi).
But your ADT response doesn't look that short IMO. It looks similar to mine. I have done really well on Zytiga.
If you are still on Casodex, I'd get off that right away as it can feed the cancer. I'd try a second-line ADT agent (Xtandi or Zytiga) before going back to chemotherapy. If it doesn't work or doesn't work for long you can always go to chemotherapy next.
This is all based on my knowledge so it's best to discuss everything with the doctors and then make a decision. Wishing you the best.
51 , 3 lesions , right apical horn , DIL, G7 , minor extrapasular, extension , 2 lesion G 6, right TZ, 3 lesion left midline G6 small, considering Tulsa dont want radiation, but seems HDR targeted therapy, MSKCC, 2 sessions 1 week apart , best option. Want. To still have kids, is all ejaculatory fluids gone or i treat hemi gland is AS for left G6 better maintain more sexual function ED not as bad, take Alfuzosin for a while , what your take?
Tulsa can be repeated with 13 month monitoring , if reoccurrance than do HDR brachy therapy targeted at UCLA is a strategy consideration. its seems latest data says Tulsa allows ED and ejaculatory ducts to be preserved
I guess you didn't read the article. A third of men had a recurrence and that was when the whole gland was treated. Potency preservation was less than SBRT, which unlike TULSA, is curative. You would probably have retrograde ejaculation. If you want kids, bank your sperm.
Your “Pet scan shows 3 spots coming back”. Where?First: I know nothing. Just know what I read and see. Much of that is mis-interpreted. Trying to give you another idea here.
Dr Kwon of Mayo Clinic says when the scan shows some spots, we Spot Weld those with SABR/SBRT, and see a return to undetectable soon thereafter. Of course if these 3 spots are in a previous Radiated zone, it would always be the call of an experienced Radiologist! Obviously . Kwons videos are up on Youtube.
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Next Treatment Step
I'm new here. Introducing myself.
Should my advanced micrometastatic treatment be more aggressive
Ending A Long Treatment Plan Sept 1st
Confusion As To Next Treatments - Carboplatin and Cabazitaxel 
