Looking for hope

I think it is too soon to say that he has not responded to Apalutimide and it is hard to be sure that he did become hormone independent that quickly - do you happen to have his testosterone readings for Sept / Oct 2021? Although it is disappointing to see a rise on a new drug, the rate of rise does seem to be slowing and it is often said by oncologists that at your grandad's stage of the disease, PSA is less important than how he is feeling. The scan data is also reassuring here. We have had members whose PSA rose to 1000 and above but they remained well for sustained periods of time. Also, if the onco does believe that Apalutimide has failed already, grandad may just sneak into the NICE rule that a man can change to enzalutimide or abiraterone within 3 months.

If the onco feels that Apalutimide is not working and grandad coped well the first time round, he might suggest docetaxel again or another chemo drug, cabazitaxel. Alternative treatments might also include swapping Prostap for Stilboestrol, an oestrogen based HT which works in a different way. Stilboestrol is an old fashioned treatment now but has been very effective for some men on this forum when normal HTs have failed quickly.