It appears cancer has spread to Jeff’s lungs. He has fluid and inflammation in his lungs which is likely being caused by the ducts that drain by themselves being clogged by cancer.
Jeff’s bone mets are significantly worse.
Jeff is no longer responding to treatment, the Zytiga/Prednisone.
Dr. Kwon called in Dr. Orme, Jeff’s medical oncologist, and together they were trying to come up with a “chemo cocktail”, but sounds like they are going to treat as a neuroendocrine cancer and Jeff will start Carboplatin chemotherapy.
PSA is too high at 65.4.
In the PET scan bones aren’t supposed to show up. Jeff’s entire skeleton basically showed up. The bone mets are everywhere.
Jeff will have radiation on his knees which may or may not help with his chronic mobility issues and leg weakness.
Last round for brain radiation is this afternoon.
I recently posted that my poor Jeff lost his beloved puppy, Mattie, to pneumonia. Mattie needed to gain her little wings so when Jeff gains his, she’ll be there to walk the heavens with him.
Meanwhile, our daughter managed to find an available 16 week old, female, English Bulldog. We went and picked up Maggie and she’s already with Jeff. Maggie has helped fill the gaping hole in Jeff’s heart.
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Carboplatin has worked for me were in a similar place my psa 91 mets every where ,just had 13th chemo round 10 days ago after Baby break. Not feeling great but if psa and mets come down then a win. Have you looked into Lu 177?
So glad you found another Maggie my new Darcy was also 16 weeks when we got him. I'm sure we are all waiting for pictures! Having a fuzzy cuddly puppy should keep you both busy, distracted and loved.
I love the way you call Jeff, “my Jeff”. Sending prayers for you, Jeff and your family. You’ve had rough times, but that darling puppy has to lift everyone’s spirits!
You wrote "Dr. Kwon called in Dr. Orme, Jeff’s medical oncologist, and together they were trying to come up with a “chemo cocktail”, but sounds like they are going to treat as a neuroendocrine cancer and Jeff will start Carboplatin chemotherapy.
PSA is too high at 65.4."
I don't think that neuroendocrinal cancer cells express psa. Though I am not an expert on the matter.
Jeff had a bone biopsy, ugh, I forget - in July-ish. At that time they ruled out neuroendocrine and small cell cancer. Jeff had stopped responding to Docetaxel, or rather, what Kwon advised was the Docetaxel had done all it could do by itself and he wanted to add Carboplatin to the chemo mix.
When the biopsy showed that it wasn’t neuroendocrine/small cell, Dr. Orme advised that Zytiga/Prednisone was the best course of treatment.
We weren’t aware this wasn’t a mutual recommendation with both Kwon and Orme. On a subsequent visit with Kwon, he explained (this is grossly translated by me), but basically he explained that while not neuroendocrine/small cell, adding the Carboplatin to the Docetaxel would be a more aggressive approach to fighting Jeff’s cancer.
Initially we thought we made the right decision in choosing Jeff’s course of treatment with Zytiga. Jeff’s PSA plummeted and he felt so much better.
Alas, here we are now …
You are correct, neuroendocrine does not express PSA.
I’m glad to hear that Maggie has joined your loving family and I’ll still keep my fingers crossed for you all as you continue with treatments.
Hugh
Omg! Stephanie you are so wonderful .. you bring tears of joy to me with a new pup . Jeff is on a tight wire . May Dear God , have mercy on your fine young man . You are his Angel ! 💔😭🙏
I'm glad Jeff has a new companion, but I am stunned by the medical developments. My thoughts are with you all. I hope Jeff can find some relief from pain.
This has been such a rough road for Jeff and you. He’s luck has been to have you by his side. Your commitment is beyond admirable. Hopefully he gets a real breakthrough soon. ❤️🐾❤️
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PSMA Pet Scan results 
PET scans
PSMA PET Scan Shows no mets?!
Axumin PET scan with undetectable PSA
