**Brief:** My father was diagnosed with cancer in 2018 and has been undergoing treatment since. He was on bicalutamide for three years, which effectively controlled his PSA levels until 2021. After that, he was switched to enzalutamide, which worked well until 2024, when his PSA levels began rising again. Recently, apalutamide was administered for three weeks, but his PSA levels continued to rise. Chemotherapy was then started, with docetaxel 80 mg in 21-day cycles. However, despite three chemotherapy sessions, his PSA levels have increased from 16  to 122 . **Question:**  Given that my father’s PSA levels continue to rise despite chemotherapy, are there any alternative treatments or options we can consider at this point? What might be causing the PSA levels to keep increasing despite the ongoing treatment? My father is 60 years old, and we are concerned about the effectiveness of the current treatment plan. Thanks