Not only do I know almost nothing about Spokane, but my local urologist
moved to CA. I'll ask around.

I.P.

Dave,

I don't know who you can see in Washington.  I live in
the other side of the country.  However I will point out
that I think the most often seen next step after Lupron/
Eligard stops working is to try "second line" hormone
therapy.  This could include estradiol patches, ketoconazole,
and/or other drugs.

I have one friend who went that route.  I think he got
about a year of low PSA out of it.  He did not complain
of any side effects and, although he was retired, I
continued to see him at our flying club, doing work and
flying his sailplane.

There are people on this newsgroup who have had chemotherapy
and can tell you how they fared under it.  Gourd Dancer
seems to have done extremely well on it.  He had chemo
four years ago, and he's still alive and kicking with an
undetectable PSA - though your mileage may vary.

Best of luck.

  Alan

Dave,

Most people who go on ADT1 start out with Lupron shots every three or four
months.  If that doesn't work, or when it stops working, they go on ADT2
which adds Casodex which is a daily pill.  That's where I am currently.
When that stops working, they used to go to ADT3, adding Zolodex, but now
they take you off Casodex next and see if that drops the PSA again.

However, you should probably wait to see what your next PSA is.  One rise
since a 0.05 is usually not an indicator to add or change treatments.