Next Level is approaching..

Hello Jess40 . I would think that you will both be wanting to return to some form of normality once the chemotherapy has finished but can sympathise with what you are going through as I know how horrible it can be to watch a loved one suffer the side effects and feel powerless to be able to do anything to make things better. In my husband's case it took about 3 months to start getting back to his old self. I think what you are asking is how can I tell whether the therapy is working? Also what does this mean for the future? Basically it is the PSA, the time to reach the lowest level and the rate at which the PSA drops from the start of treatment can tell the experts how things are going. Also the PSA density at the 3 month stage has a predictive role as does whether there were any visceral metastases. The CT scan will show how much the lesions have shrunk. Age does not seem to matter. Being able to cope with the Triplet Therapy and completing the course is continuing to show the best outcome with the greatest time before recurrence and I hope your husband sees this benefit for a long time. There is a recent article which studied the PSA kinetics of ADT and Darolutamide but remember that with the addition of Docetaxel the time to recurrence is pushed out a lot further.

https://link.springer.com/article/10.1007/s11255-025-04465-7

Your main question then is how is your husband going to be monitored in the future. Also would he benefit from something to help strengthen his bones - my husband has regular injections of Denosumab alongside calcium and vitamin D supplements.

Hi, thankyou for your very informative reply <3 and the article.

Our problem is that there is no PSA to speak of, the cancer had already destroyed the gland by the time it was diagnosed - so little PSA is being produced.

When H had a regular PSA check at the GP, there was nothing to indicate any issues - and slowed down the diagnosis even further. Therefore, they're not using that at all in monitoring onward changes. He had an MRi 2 months ago, that showed the lesions were less vivid, which was a boost for us all, and really has helped him to continue.

How often does your husband have the Denosumab? I shall ask about this at the next appointment. H has been taking vitamin and mineral supplements since Christmas, in the hope we can maintain his immune system.

Thankyou for your kindness.

My husband is also a low secreter so I can understand your difficulty. In his case he is monitored with a combination of MRI, CT but when there is a small rise in PSA he has a PSMA PET scan but you need to have a PSA above 0.2, but preferably above 0.5. Our oncologist likes to keep an eye on the PSA because it can also be produced in the adrenal glands and salivary glands which it showed up in earlier this year along with new bone mets so we are a lot further along this journey than you are.

My husband has an Xgeva 120mg injection every 2 months.

Thankyou again, I've made a note of this, and will ask.

Can I ask how long you have been on your journey?

H started with bone pain last summer, but he's experienced ED to some degree for five years and ignored it, believing it was his 'age'. He's 65.

We are coming up to 5 years now and still hope for at least a couple more but hubby is 81 although still strong and young at heart. It has been a rollercoaster with progressions at 18 month intervals in 2022, 2023 and then this year. Positivity is important and we have an excellent medical team keeping him going.

Hello Alwayshope,

That is so good to hear. I agree with regards to the positivity, my H has been very negative up until the last month or so. I feel he's found some inner strength at last, a little headway has been made.

We've faltered with medics, but I believe we have a great consultant now. 

Wishing you both strength and good health.