4 stage cancer Gleason 4+4

Not a doctor but I had a similar diagnosis as your dad and have been following advances in this field. There are other drugs that seem equally effective as abiraterone, such as enzalutamide and apalutamide. Have you discussed these alternatives with the oncologist now that your dad does not tolerate abiraterone well. Also, you may want to look into add-on radiotherapy, typically offered a few months after ADT, if your dad has so-called low-volume metastasis. The benefits likely outweigh risks in your dad's situation. I had stage 4 (pelvic bone metastasis) and Gleason 4+5 about 10 years ago. Received combined ADT albeit a less effective one (abiraterone was expensive and not first-line at that time and others like enzalutamide were not available) and IMRT 6 months into ADT. The radiation oncologist carefully circled all lesions on MRI during treatment planning. Today there are PSMA PET/CT and proton therapy, which are better options than what I had. Best luck with your dad's treatment!

Hi,

My thoughts kinda parallel Inforeach, I would think there would be some kind of radiation therapy in his near future? ADT will not kill his cancer but only weaken it! If you have access to PMSA PET scan that is a great tool in identifying cancer locations.

Dave 3+4

My PSA level has been <0.1 for many years. But it's hard to say if cancer is gone as I was never given a PET. I follow with my oncologist twice a year and undergo CT yearly. A lung nodule also needs follow-up. Otherwise, MRI could be a better option.

In the beginning of this journey, I read all types of educational contents, including diet considerations. I did limit animal proteins except chicken and fish. I know scientific data are scarce in that regard but diet restriction was not difficult for me so I just followed anything that is no risk. I'm now less restrictive on diet but still stick to a heart-healthy diet. Hope it helps.