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One thing, PCa metastases are more related to your Gleason score. Gleason 6 almost never goes metastatic, while 8,9, and 10s often do. If you are one those, the longer you have PCa, the better the chance your cancer will mutate into something more aggressive.
I have been on this road for 9 years now and my first major change came earlier this year. I became castrate resistant, as you know my cancer mutated so the first line ADT drugs were no longer effective.
