Tale in Bio.
Basically put out of mind since before Xmas. Effectively managed side effects of decapeptyl plus darolutamide. But Stage 4 advanced metastatic, almost certainly low-excreting, recurrent is what it is and will be. Yesterday longest cycle ride so far this year at 27 miles helped divert my attention and energy ahead of blood results and "review" tomorrow.
And today I feel, well, the weight that I have so far ignored. I know that whatever the psa and testosterone numbers are is largely irrelevant, yet I am still dwelling on "what if x or y??"
I haven't even done my usual briefing note, Qs to ask etc, although i need to decide on bone strengthening infusions. Resignation, verging on apathy, rules. Any form of radiation ruled out as soon as PSMA PET results seen, so only "choice" is to add chemo or not. Pretty much decided not. No other extra treatments except some still experimental interventions (cost up to 180,000 quid p.a. which entirely reasonably NHS not deploying!).
Working back from recurrent psa numbers only possible prognosis less than 12 months - on which I shall press Consultant if he deigns to see a lost cause in person this time!
All in all a bad day. Feel a bit better for writing it down!
Sorry for rambling, good luck all, Dave.
Hello Dave
As you are aware we have Stage 4 Community members on here who were diagnosed over 10 years ago - so look on the bright side!
Chemotherapy if it’s offered could extend your life by years and as it affects everyone in a different way - if it’s offered, why not try it - if it doesn’t fit then stop it!
We don’t consider anyone here a “Lost cause” and I am sure you would rather keep on riding your bike than the alternative.
Think about it - life’s good, I should know, I almost lost mine!!
Best wishes - Brian.

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Good luck for tomorrow Dave.
I think we have at least one thing in common, making decisions and sticking to them. I've had chemo twice - 2014 after surgery for lung cancer then 2024 after recurrence of prostate cancer (had RT/HT in 2016).
On each occasion I decided before chemo was offered that I'd have it on the basis I could start it and if the side effects were that bad I could stop any time I wanted - they can't make you have it all. I did complete both and so far all remains OK (fingers firmly crossed).
Hope all goes well, all the best,
Derek.

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Thanks all. Sorry for delayed response - for some reason not got/getting notifications of replies to post!
The costs in side effects v benefits in life lengthening v QoL are indeed a fine balancing act. Tossing a coin possibly as good a decider as any........
Onward and downward.
Good luck all, Dave
Update, 9/3/26.
Saw the main man today. All pretty low key. He's clearly old-skool, driven solely by psa numbers - and on that basis I agree a very good outcome.
PSA down to <0.03 from 4.5 on 13/10/25. A 99.3% fall in 20 weeks of decapeptyl and 16 weeks of darolutamide. This appears to be "an extremely encouraging.... deep and rapid response." (Not his words - he doesn't say much!)
Simplistic IMO and in answer to my Qs he simply said scans not part of routine monitoring. I shall have to look into complementary private sector investigation.
I decided not to rock the boat nor risk side effects so declined bone density meds and/or chemo. Dr S said if I wanted either fine, but that he would not push me. Agreed that chemo may not make much difference to progression at this stage.
4 mths of darolutamide issued. Next psa test in 3 mths followed by a phone call from an oncology nurse.
Othrr than psa he mainly seems to go by "how do you feel?". Because I am relatively active he judges me well.
Could have been worse!
Good luck, Dave
Eh up Dave,
Me thinks the treatment is working and along with all that exercising you will be here for yonks!
Carry on carrying on!
Best wishes - Brian.

Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
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I'm very pleased to hear this Dave, prostap and darolutamide (following chemo) has been working for me too (last PSA undetectable). Hoping this continues at next blood test in 3 weeks.
All the best, Derek.

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