In the last 4 years, since failing Enzalutamide I’ve been successfully zapping Mets. In all cases, after radiation my PSA drops from about 20 to 3 slowly over a six month period. PET scans show only 2 Mets at a time. I’ve now had 6 treatments over the past 4 years, EBRT 60gy 30 days. Except for a lymph node all Mets have been on my right pelvis. It’s taken it’s toll, I’m limping and can walk for only 20 mins. My MO (like TA) reckons radiation is for pain relief. My RO reckons, in my case, the treatment works.
After my last zapping in Aug my PSA got down to 6.8 three months ago, but has now jumped to 15. If the Mets are anywhere near any previous zapping I can’t have radiation, in fact, if it’s the right pelvis I won’t. I’m 70 should I be opting for Chemo, “sooner rather than later”. Or, if it’s one or two mets and not on my right Pelvis zap em again. Any advice.
Radiation or Chemo first? 
Chemo+ radiation+combo hormone therapy
Cancer Recurrence After Radiation/Chemo
Done with chemo again!
PSA post salvage radiation
There is no proof that playing whack-a-mole accomplishes anything. If you continue with systemic therapy and the zapping is in safe places, why not? You are making the common mistake of thinking your PSA is your cancer. It is not. It is just a protein that larger tumors emit- so when you zap the ones you can see, that leaves probably thousands of micromets that you can't see. You have let those micromets establish themselves and grow just because your PSA was low. Systemic therapy is what you need.
prostatecancer.news/2020/07...
Thanks TA