You could try the second line hormone therapies: estradiol patches, DES, emcyt (they can work against hrpca and cause direct apoptosis of PCa cells...probably won't get them all but is useful) or ketoconazole is another drug that works (how long on anything is the biggest question) and there are others. Estradiol patches have little or no side effects and DES in much safer that the alot of the b.s. that is thrown out there about using such.(just use 1 mg or even less-could be cut it in half and use coumadin in conjunction). The old days decades ago the well meaning medical idiots used 5-mg and no blood thinner or aspirin and a few patients got blood clots, this is what everyone remembers. They don't mention their successes using this and very good control for thousands of patients, while using this for decades before the expensive newer (better?) drugs came out.
I have used DES for 2 yrs., sometimes on/off, sometimes maybe randomly, it outperformed the ADT3, it canceled those ADT side effects and the only issue I ever felt was some breat tenderness. It cost almost nothing (no patents, no drug companies...it is man made compounded drug). If you were paranoid about using this, then use the estradiol patch it also works similarly (same family of drugs), people say they have no side effects, except maybe the breast tenderness. Dr. Premoli in Argentina uses the patches on his patients, they don't have mega bucks and insurance companies to send the thousands of dollars to.
Dr. Fred Lee the pioneer doc of cryo-freezing PCa methodology is also a PCa survivor his choice of drug is emcyt (same family of drugs), so yeah he would be an idiot too if you believe the b.s. hype on using these types of drugs. (this does have side effects and is probably not used that much). You would have to find the right doc in order to get a written Rx for these drugs or even the ketoconazole. If you are seeing a uro-doc, you are beyond what he can help you with.
Chemo in my opinion is a possible later consideration and would drag your body down, myself I would wish to avoid forever. I feel so much better not using ADT(3) drugs that most people would not believe it, got rid of the weight gain, no sweats, no hot flashes, and that bunch of lousy effects. (have much better strenght and energy now too. Plus got a chance to flip the bird to the nice drug companies whom cashed in tremendously for my first 2 yrs. on ADT3=$26,000+. Yeah I'm an idiot for using it ... (cost=$130 per year). Yes there may be some patients whom should not use some of these drugs, if they have high end blood clotting factors kind of built -in to their own chemistry, but this can be tested for too.
Anyway food for thought, controlling PCa is probably better than letting run rampant on its own. Contact www.paactusa.org a leading PCa advocacy organization for patient whom are at risk is another option.
Dx-2002 (probably shouldn't be around this long with my original stats and total urinary blockage likely caused by PCa in 2002, way high stats found all 12/12-cores 75-95% cancerous, gleasons 7,8,9's, bpsa 46.6) (current psa .78 resumed DES again recently and got 3rd response in so using it)