Up again!!

It's alright the medics saying not to worry but if you were my dad, I would be wanting a new plan of action asap - you clearly have active cancer somewhere. Did you have the PET scan last Summer and, if so, did it show anything? Can you remember what kind of tracer was used ... choline, FACBC or Gallium 68 perhaps?

If the PET scan last year was clear, I think I would be asking at the next appointment for a new scan, possibly using a different tracer. I would also expect the bicalutimide to be changed to an injectable hormone - these work quite differently to bicalutimide. On bical, your testosterone is 'disguised' so that the prostate cancer cells can't find it and feed on it - the injectable hormone therapies stop your body from producing testosterone at all. The trouble with bical is that prostate cancer can learn to find the testosterone and / or the bical 'feeds' the cancer. My guess is that at some point soon, your oncologist will either stop the bical but not replace it with anything to see whether you get an anti-androgen withdrawal response (for some men, stopping the bical makes the PSA fall and controls the cancer for a few months) or will stop the bical and put you on Prostap or similar.

If they do another scan and something shows up like a bone met or lymph node, they may be able to treat that met but if the scan shows lots of mets, that is not possible and they may talk to you about trying chemo to help the HT work more effectively - or about having two hormone treatments together to hit it hard.