Bad news, bone mets on scan. Basic questions

So, my dad's F-18 PET/CT scan showed multiple bone involvement. Not sure if that means oligometastatic, or metastatic, waiting for our oncologist to write back.

We've changed oncologists to Dr. Myers, and are very optimistic we'd be deploying the full arsenal under his guidance.

But, human nature being what it is, while we're waiting for the next consultation, I wanted to ask folks who've dealt with a similar situation about what are some possible directions in what happens next in their experience, what was their experience in controlling the initial appearance of bone mets. We were surprised to learn he's got bone involvement with low overall PSA numbers, but understand that the F-18 PET/CT scans can pick up stuff that would have been undetectable before. So we're taking this a good news, to have caught the progression before it became symptomatic or widespread.

As of last test, his PSA is at 1.3, falling slower now from a high of 14 in December. We're on Trelstar, Casodex and Avodart, but are planning on switching Casodex for Xtandi to force a faster PSA drop (in case hormone resistance sets in over the next few months). We've got a few basic questions.

1) Can this combination of HT (including Xtandi) clear bone mets, or are chemo and Xofigo the only medications that eradicate bone mets?

2) If a full remissions doesn't happen, is it possible for bone mets to be stabilized for some time? In other words, are we talking a linear progression once you've got bone mets they just grow exponentially, or is it more of a battle (some mets disappear, while others remain, etc.)?

He's a G7, since 2000, so we got used to a stream of good news for over ten years, which is now basically over. So, it's hard, but we're really not ready to accept the end just yet. He's been asking us how much time he's got. His buddy told him 1-2 years based on his own father's experience. I told him that's ridiculous, not today, and not with the medical oncologist he's got. On the overall, however, he feels great, no pain, active, so we're optimistic that we'll stabilize the situation, even if he's now with bone mets.

Arthur

Excellent understanding of where your Dad is. I know very little about advanced cancer, just wanted to congratulate you on your heads up. I am curious about your use of over 10 years. Granted it is over 10, but why not say over 14 or simply 15 years. Shouldn't he have the standard bone scan for a definitive diagnosis. Again I may be behind the scan power curve, but didn't realize a cat scan even the jet model, was definitive. If they are not and some one know please share with the forum.

Thanks Jerry and Logo!

Jerry: that's very encouraging to hear, that a remission is possible, even if not all bone mets disappear completely. Even if he is becoming hormone resistant, we're hopeful that Xtandi and whatever else is thrown in would give us some kind of a remission.

The consultation visit with Myers was very encouraging. He spent two hours with us, chatting about the various possibilities and answering questions.

Logo: Yes, we have to do a Dexa bone scan as well, that's next on the list. If the F18 shows a false positive, then we'll take that as an extra bonus. And, you're correct, it's been 15 years!

Arthur

Infohound2,

Thanks so much for sharing your husband's experience. After hearing your collective stories, my dad's much more optimistic. We're looking forward to Dr. Myers updated suggestions. I'm curious if he'll add anything beyond what he said originally, which was to add Xtandi in place of Casodex.

Arthur