Hi, my OH (aged nearly 80) and G9 Tb3 N1 M1 was put on Abiraterone and prednisone and again needed the steroid switch to dexamethasone but his PSA kept rising. He was then given a PET PSMA CT scan which showed quite rapid growth on the thoracic spine. His PSA is around 67. He declined chemo but was offered either radiation to the spine or Ra-223. He will be going with Ra-223 but we don't have any dates yet. Abiraterone stopped with no bad effects but the weaning off dexamethasone was bad - he stopped eating and felt really bad. His oncologist has put him back on a small dose of dexamethsone and finally he has improved. He has the swollen ankles, needs compression socks and I am not sure where that came from. After Ra-223 I am not sure there is anything else they can give. I do worry that after 7 months on Abiraterone that never worked he is in danger of the spinal mets becoming t-NEPC, which is treatment induced neuroendocrine prostate cancer, which means the cancer cells mutate not to need the Androgen Receptor Pathway and get quite aggressive. But there is always something to worry about. Good luck.