Treatment or Dr recommendations please.

[Papalee]

My dad was having issues urinating. After several months of trying to get him to a Dr. he has a really bad episode and was unable to urinate at all.

He was taken to the ER, and home with a catheter the same day. Needless to say, we were scheduled for Surgery with a biopsy due to PSA levels over 25 and Gleason scores were a 9.

60 percent of the tissue removed was cancerous.

2 weeks ago he had an CAT and Bone scan that showed the cancer had mestatsized into his spine pelvis and knee. We were told that they is not a candidate for radiation. He recieved his first hormone shots today. We live in SC and my father is 72. It's a difficult situation for all of us because he suffers from a mental illness that prevents him from making decisions . Any suggestions or doctors in the area or advise is appreciated. Thank you.

[YostConner]

While pelvic radiation would not be a course of treatment, targeted palliative radiation should still be available if your dad needs it. It's a difficult time for you, but hopefully the ADT shot will lead to a PSA reduction. If it does, that's awesome. If it doesn't there are still options--other drugs, chemo, trials (though trials my not be available in his condition). Try not to despair. These treatments aren't curative, but they may slow things down.

[Dr_WHO]

So sorry that you are here and that his case is advanced. It is hard when someone tells you that you or a loved one has cancer. It is even harder when they till you it is advanced. Please know that there are others who have been here for decades after they have been told they have advanced cancer.

You may want to review the results from the Stampede trial that just published this month. In short there is a very significant increase in lifetime when you use Lupron and Zytiga together (two hormone based drugs). My medical oncologist was at the conference where they presented the results. When she got back home she added Zytiga to the Lupron that I am already on. A cold of the article is listed below:

nejm.org/doi/full/10.1056/N...

Our thoughts go out to you and your family.

[afab]

If your dad is still carrying around a catheter, hose and bag, I'd suggest that he self cathaterize a couple of times a day . Much better than carrying around a bag, hose and catheter.

[Sisira]

Papalee,

Sorry to have learned about your father's condition. Be hopeful of the treatment options available to get the decease under control with the help of a good Oncologist and a Urologist.

I am with Dr-WHO and I don't want to repeat the same good advice that he has given you.

Appreciate your deep concern regarding your father's health and wish you the best.

Remain with us and be relieved.

Sisira

[AlanMeyer]

Hello Papalee,

I have had experience with Alzheimer's Disease in my family and I know what a tremendous complication it is for any medical problem. If your Dad has that, or another dementia causing health problem, it will be desirable to have everything be as simple as possible.

The usual first treatment for prostate cancer is androgen deprivation therapy ("ADT"). The most common treatment for advanced cancer is a drug like Lupron (or similar Zoladex or Eligard). They are relatively easy to take, requiring no daily pills and an injection just once every 3 or 4 months. Adjuvant (i.e., at the same time) chemotherapy is now recommended for more life extension, but I don't know if that's a good idea for your Dad since he would have to go to the doctor for treatment every three weeks, sit in a chair with a needle in his arm and ice on his hands and feet for 60 or 90 minutes, and deal with possible nausea or other side effects for days afterward.

If I were suffering from dementia and had enough wits about me to make a decision about cancer, I'd want treatment that would help me cope with my condition by making things easier for me and preventing or reducing hospitalization and pain. Extending life wouldn't be high on my priorities. ADT might do that for some time. After that I'd want to be treated by someone who is an expert in managing cancer pain - at home if practical or at a nursing home if necessary.

Also, your Dad and the family should take care of as many financial issues in your father's estate as possible, getting everything on as secure and stable basis as possible since illness and dementia or other mental issue make everything progressively harder as time passes.

Best of luck.

Alan