unfortunately, new to stage 4 club

[Crwatapc]

I had posted before:

64 current psa post op 0.39

PSMA showed left internal iliac node - likely more at this psa level

I am not a candidate for rad rx due to previous pelvic radiation prior earlier in life

Will have to start on ADT soon:

- best meds? Doublet since low burden at this point

- Tamoxafin to prevent gynecomastia

- side effects - hit or miss

- decipher score a was 0.9/1, Gleason 7(3/4)

- seems I am on the palliative care path -

[Tall_Allen]

You probably won't need tamoxifen with ADT.

[Kaliber]

welcome brother …. You are among brothers and sisters that “:get it “. If you just need to rant or need a compadre to talk to, don’t hesitate.

The medical knowledge here is the best.

You don’t seem to be palitive care material quite yet, but that’s a choice you can make anytime. Palliative care will focus on making you comfortable and your quality of life. Your loved ones can be treated by palliative care for mental stress etc. , as well. This when you are ready for palliative care. You’ll probably know when you need extra attention because of discomfort and mental stress of your own. Your oncologist will treat you the same in palliative or not in palliative care, but this stuff can wear on you, or you might just plain need a better , more comfortable, everyday life.

I’ve been in palliative care for a couple of years now, out of my over 6 years of care, I highly recommend them, you’d be surprised at the innovative care and help they will provide. My palliative crew works VERY hard , mostly behind the scenes , to make my remaining time the best it can be. Kinda like angels on your side helping you. Your treatment facility has a palliative care registry, when you are ready, ask your oncologist to enter you to the registry. Lots of perks being on that registry as well.

❤️❤️❤️

All of this just IMHO and based on my direct personal experiences. Your medical team should always be consulted ultimately.

[Derf4223]

If nothing else, having APCa is a test of one's will to live. You can reduce morbidity odds by lots of resistance/cardio exercise. Going with a heart and cancer friendly diet is also highly recommended as it would be a shame to just give up and let other unpleasant fatal maladies take you out too soon, if your PCa doesn't. Ask your doctors for aggressive treatment.

Speaking of treatment, triplet therapy (ADT/abiraterone/chemo) was shown to help even cases with lower tumor loading.

The name of the game is to survive until better treatments are available. The treatment landscape has already changed a lot since my Dx in late 2021. So far I am fortunate to be an exceptional responder to RT + doublet therapy, but I try to keep current as well as I can.

Regarding RT, were you told you were not a candidate by an RO? Today's RT is very precise and can radiate individual tumors no problem. Have you had a PSMA PET/CT scan?

Another route is to see if you are eligible for trials, ideally giving you early access to treatments already proven out in more extreme cases. Many love cases like yours.

[Crwatapc]

Prior RT places me at very high risk for significant toxicity to bladder and rectum - quality of life issue. Don’t want to end up with 1 to 2 external bags in light of the fact that external beam radiation may not even accomplish any thing at all. I likely have micro metastatic disease and the rad onc said the risk to radiate me was too high.