Should I choose radiation and hormone therapy for oligometastatic prostate cance...

This is such a significant decision, and it sounds like you're approaching it thoughtfully by working closely with your medical team and weighing all the factors that matter to you. Treatment decisions for oligometastatic prostate cancer can be complex, with various factors to consider including overall health, treatment goals, and personal preferences. Many people in this community have faced similar crossroads and found it helpful to seek second opinions, ask detailed questions about potential side effects and outcomes, and take time to fully understand their options. Your medical team will be the best source for guidance specific to your situation, and this community is here to support you through whatever path you choose.

Thank you

Dear Age 79 Gleason 3+4—I am Dave Stauffer, age 77 Gleason 4+4, diagnosed August’23, 42x radiation and 4 months ADT. In two years post-treatment I had no recovery and wish I’d had no ADT. I suggest you be very wary of over treatment, especially if you happen to be very fit. Get more evaluation and consultation! Find more patients with your demographics and complications. You don’t have to rush your decision! I wish I’d done at least three months more research and reading—I’d be in better shape now and not so resentful and bitter toward care team that failed to say anything about numerous side effects that now degrade my quality of life every waking hour.

Dave, thank you for sharing your experience and advice. I will certainly heed your suggestion. Has your cancer responded to this treatment protocol at all? Again, thank you. Tim S

I’m 76 (75 at diagnosis). Gleason 9 and 10. No metastasis. I did 45 sessions of proton beam radiation (Oct-Dec) and I’m on Orgovyx and Nubeqa since October/November. . Last PSA was 0.08 and getting another one in mid April. The drugs are no fun…dealing with some fatigue, hot flashes, testicular pain , muscle/joint issues , and not so great blood levels (higher glucose, anemia, low white blood cell counts) but so far radiation seems to have done the trick. Hopefully, the drugs will keep things quiet so I can continue to get frustrated with the game of golf!

Thank you for the reply. I wish you well with your golf game. Hit ‘em long and straight. Tim S

Tim S — you ask if my cancer has responded. Yes! I’m 21 months out from treatment and PSA remains <0.01. But side effects have exacted a high and increasing price in castration, incontinence, hematuria, infection, lack of concentration, etc., with ongoing deterioration. So life becomes the constant weighing of benefits vs costs, with most of the joys—competitive running, community volunteering, sex—only a memory. And probably all avoidable if the NCCN hadn’t done away with age-70+ screening. I apologize for my flight of fury; you asked a simple, straightforward question and got a screed!

Sorry for your plight. I am in the initial phase of my treatment and with your experience in mind, I’ll continue to monitor side effects. Again thank you for sharing your experience.