My husband (77) was diagnosed 4 years ago - initial PSA of 139 and a Gleason score of 9. He has been on hormone therapy since then and also takes bicalutamide daily. Initially, his PSA dropped to minus numbers, but it has gradually been creeping up since last year. His new PSA level, as of today, is 12 and has doubled since March. He will now be going for another bone scan and CT scan. May I ask what is the next usual step in the treatment process? He hasn't had radiotherapy or chemotherapy. I've put this in the localised cancer topic as his first bone scan and CT scan, four years ago, was clear at that time, although we were told that with such a high PSA level it was highly likely that the cancer will have spread, but couldn't be seen yet.