I'm looking for some help in deciding what to do next with my dad. He was diagnosed in march with Gleason 9 and extensive bone mets. His psa was 200 at the time. He started on Lupron for the first month and he psa dropped to 45. Then was switched to firmagon which his urologic oncologist and urologist thought would be Better for him. His psa was Like a roller coaster, up and down for 5 months with the lowest being in the 60's. They then switched him back to Lupron with 50mg casodex. First month it went down to 35 and we were all elated! We thought it was finally working and going in the right direction. Then the 2nd month on Lupron/casodex went to 88. Went to oncologist he took him off casodex. 2 weeks later his urologist took his blood after he gave him his Lupron and it was down to 78. Then 2 weeks later went to have blood drawn again because it was 30 days off casodex(which dr. Thought may have been causing his psa to rise) and psa was at 106. Today he's going for a bone scan and catscan to see what's going on in his body. Tomorrow we meet with a new oncologist at Cleveland clinic to go over the results from his scans. He hasnt been feeling good and has lost 10 lbs in a month. He told me today that he wants a good quality of life the dr mentioned zytiga and chemo as possible options depending on the results. Just wanted some input before we go tomorrow. I was thinking of making an appointment with dr. Snuffy meyers since this seems to be his area of expertise. I'm always researching and reading the posts on here to get info. I just want to make sure I'm doing everything I can to help him. I'm so sorry for everyone having to go through this. It's devastating! But we will all stay strong or our dad. Please any info/ suggestions will help. Thank you in advance!