Brief Answer: Survival good for declining PSA,Oncologist needed Detailed Answer: Thank you for asking XXXX I am Dr S Khan and i would like to answer your query regarding prognosis and survival odds in advance prostate carcinoma with metastasis and hormonal therapies. XXXX i want you to know that survival odds for any prostate cancer with hormonal therapy are decided by these following factors. Karnofsky Performance Status (KPS) Hemoglobin (HGB) value PSA Lactate dehydrogenase (LDH) value Alkaline phosphatase (ALK) value Albumin value XXXXXXX score- Percentage of biopsy cores positive for cancer Clinical tumor stage Age at diagnosis now in your case , age of 69 with high grade and XXXXXXX scoring all points to a worst prognosis. But it is a hopeful sign of PSA levels reduction on leuperolide therapies. The change that drastic from 30 to just 2 is a good omen. Also Several molecular markers have been shown to aid in determining the prognosis of patients.Genetic markers like PTEN, P53,MYC, TMPRSS2–ER etc all decide what will be the fate and also decides the survival odds. A recently approved alpha-emitting product radium-223 (Ra-223; Xofigo), has been shown to increase the survival from average 3.4 months to 14 months. There have been many Nomograms developed from different sources to predict the survivals and life spans after different treatments and they have varied. In nutshell , i want you to think positive and seek your oncologist opinion in this regard.As your age and prostatic stagings indicate a poor prognosis and your recent PSA improvements indicates a completely contrary picture. But lets be on the brighter side and hope for the best. As it is said "Never think about how much moments are left in your life, just think how much happiness you can have in every moment left" I hope and am sure that it helped. Take good care of yourself and dont forget to close the discussion please. Regards S Khan

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