Usually after the failure of one of the new anti androgens chemo or Lu 177 PSMA may be possible treatments. Other possibility (outside the SOC) when the mets show in the PET/CT is to do SBRT is there are less than 5 mets and they are accessible to this treatment.
If and when the mets appear, consider getting a direct biopsy of the cancer and do genetic and IHC studies. They may indicate the cancer may be susceptible to PARP inhibitors or Keytruda alone or in combination with zytiga or enzalutamide.
If you did not have Provenge, consider requesting this vaccine which could prolong life.
Hello Your story and mine are very similar. No prostate, Lupron and Nubeqa, undetectable Testosterone ,PSA 9,85 and climbing- doubling time around 4 months. All the same scans done a few weeks ago : negative.
My onco, Dr Saad is top shelf.
And same conclusion: scans will dictate path forward
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