I was diagnosed with an aggressive type of prostate cancer in Nov 21. Prostatectomy in Mar 22 and thought all was ok until early 23 when my PSA level rose rapidly. The cancer had spread to my spine, ribs, hips and right femur. Chemotherapy (Doxatel) in May-Jun 23, 6 sessions booked but was pulled after 3 sessions due to adverse effects on my lungs. Radiotherapy in Nov 23 and Jan 24 to my upper and lower spine. Sep 24 my PSA levels rose from 0.01 to 2.59 in a few weeks, a scan showed it was back on my hips. Radiotherapy on 7 Nov and hormone/steroid treatment starts tomorrow for as long as it takes. Added to this I discovered I had fractured vertebrae in Sep last year and this year which I thought was a bad back LOL. I’m 70 but already planning for my 90th birthday 
I believe positive thinking really does help.
Hi !
I’ve seen some studies or trials where they do a sort of ’debulking’ by RP and then adjuvant radiation therapy with of course long term ADT for high risk prostate cancer.
I’m not really sure of the exact purpose as there are ’standard’ treatment pathways for high risk locally advanced / locoregional / oligometastatic prostate cancer with radiation and boosts in prostate, also Docetaxel in the mix perhaps and in the case of oligometastatic, adding SBRT to those few distant mets and of course long term ADT and perhaps even Abiraterone.
There are lots of interesting treatment pathways and more is coming 
Best wishes - Ulf
