APC story of my dad

[Shumaf]

My dad was diagnosed with advanced prostate cancer in May 2016. Initial PSA was 25 and Gleason score 9. It was already spread to the bladder. His prostate and bladder was cleaned by an operation. After the operation he was given hormone-therapy for 3 months. After 3 months his PSA was increased to 53. The metastases was spread to spine, ribs and hip bones and lymph nodes.

After that he was scheduled for a radiotherapy treatment of the prostate and surrounding tissues and consequently chemotherapy with Docetaxel (x6). Because of the combined side effects of radiotherapy and chemotherapy, his physical condition was deteriorated dramatically in the first few weeks. He was treated at a Hospital for couple of days in order to improve his general condition. His condition was slowly improved and the side effects were better manageable after 2nd chemo cycle. His PSA was dropped to 0.3 after 6 cycles of Docetaxel.

He spent 6 months without a major health problem after chemotherapy. But then, his PSA increased to 1 after 6 months and jumped to 3.8 in another month. The metastases was spread further to other bones. He has been given Zytiga 4 weeks ago (August 17). Now his PSA is dropped back to 0.5 after using Zytiga (4 pils a day) for a month. He had almost no side effects of Zytiga so far. He will be on Zytiga for another two months initially and will be followed by another PSA check and a screening.

[JamesAtlanta]

That is quite a story. So sorry your dad and your family has had to go through all this. He is lucky to have what is obviously a caring family to help him on this difficult journey

Sounds like he's responding very well to Zytiga. That is wonderful news!

Our prayers go out to your dad and the rest of your family! 🙏

[Shumaf in reply to JamesAtlanta]

Thank you for your nice words James!

[Sisira]

Considering the very adverse pathology your dad has already started with, his present status with the second line hormonal treatment ( Zytiga ) is quite impressive. Hope he is using Zytiga with a steroid ( Pednisone ). Since his Gleason 9 cancer is spreading extensively to his bones and the worst scenario could be Spinal Chord Compression leading to paralysis, it would be advisable to discuss with your oncologist whether he could be treated with Radium 223 ( Xofigo ) to destroy the bone metastases. Enzalutamide ( Xtandi ) can also be tried when Zytiga fails. Chemo-hormonal therapy ( combined ) may also be used in accordance with the STMPEDE, CHAARTED and LATITUDE Trials. And also second line Chemo Therapy ( Platinum combined ) . Make sure you have a very good Oncologist who is specializing in treating PCa, to discuss all these for the well being of your dad.

Blessings for your dad and also for you!

Sisira

[Shumaf in reply to Sisira]

Dear Sisira,

Thank you for the ideas and advices. He will have PSA check and scans in two months. I will keep those options in mind if the his response to Zytiga changes.

I have read that Xofigo can be used in case there is only bone mets. Since my dad had already bladder and lymph node mets, i m not sure it is appropriate for him. Anyway i ll keep in mind as an option.

Bless you